Provider Demographics
NPI:1093924284
Name:MCMANUS, THOMAS MORGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MORGAN
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2224
Mailing Address - Country:US
Mailing Address - Phone:203-389-2032
Mailing Address - Fax:
Practice Address - Street 1:4 WILDWOOD MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1154
Practice Address - Country:US
Practice Address - Phone:860-767-2314
Practice Address - Fax:860-767-2327
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice