Provider Demographics
NPI:1396854147
Name:MANNING, DEAN B (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:B
Last Name:MANNING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 W NINE MILE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9423
Mailing Address - Country:US
Mailing Address - Phone:850-332-6370
Mailing Address - Fax:850-332-6940
Practice Address - Street 1:2600 W NINE MILE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-9423
Practice Address - Country:US
Practice Address - Phone:850-332-6370
Practice Address - Fax:850-332-6940
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist