Provider Demographics
NPI:1164606356
Name:RANA, MANISH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:
Last Name:RANA
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 1:400 WEST CRAWFORD AVENUE, SUITE C
Mailing Address - Street 2:MONTERY DENTAL CENTER
Mailing Address - City:MONTEREY
Mailing Address - State:TN
Mailing Address - Zip Code:38574
Mailing Address - Country:US
Mailing Address - Phone:931-839-8684
Mailing Address - Fax:931-839-3299
Practice Address - Street 1:400 WEST CRAWFORD AVENUE, SUITE C
Practice Address - Street 2:MONTERY DENTAL CENTER
Practice Address - City:MONTEREY
Practice Address - State:TN
Practice Address - Zip Code:38574
Practice Address - Country:US
Practice Address - Phone:931-839-8684
Practice Address - Fax:931-839-3299
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice