Provider Demographics
NPI:1386662443
Name:RAMIREZ, MANUEL G (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:G
Last Name:RAMIREZ
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 1:2277 E WILCOX DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2755
Mailing Address - Country:US
Mailing Address - Phone:520-459-1512
Mailing Address - Fax:520-439-0458
Practice Address - Street 1:2277 E WILCOX DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2755
Practice Address - Country:US
Practice Address - Phone:520-459-1512
Practice Address - Fax:520-439-0458
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice