Provider Demographics
NPI:1518149780
Name:MANNING, WEBER WINSTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WEBER
Middle Name:WINSTON
Last Name:MANNING
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 1:990 JUNE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3702
Mailing Address - Country:US
Mailing Address - Phone:901-767-2290
Mailing Address - Fax:
Practice Address - Street 1:990 JUNE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3702
Practice Address - Country:US
Practice Address - Phone:901-767-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice