Provider Demographics
NPI:1346422730
Name:DHUTIA, MANISH (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:
Last Name:DHUTIA
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21929 HIGHLAND KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5873
Mailing Address - Country:US
Mailing Address - Phone:281-395-8488
Mailing Address - Fax:281-395-8487
Practice Address - Street 1:21929 HIGHLAND KNOLLS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5873
Practice Address - Country:US
Practice Address - Phone:281-395-8488
Practice Address - Fax:281-395-8487
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics