Provider Demographics
NPI:1477747897
Name:MANESS, WILLIAM L (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:MANESS
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 1:28 ATLANTIC AVE
Mailing Address - Street 2:SUITE 237, LEWIS WHARF
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110
Mailing Address - Country:US
Mailing Address - Phone:617-227-4831
Mailing Address - Fax:617-227-3174
Practice Address - Street 1:28 ATLANTIC AVE
Practice Address - Street 2:SUITE 237, LEWIS WHARF
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:617-227-4831
Practice Address - Fax:617-227-3174
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA116141223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics