Provider Demographics
NPI:1558537399
Name:J TRAHEY MANER DDS PA
Entity Type:Organization
Organization Name:J TRAHEY MANER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TRAHEY
Authorized Official - Last Name:MANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-441-1006
Mailing Address - Street 1:2518 S CROATAN HWY STE C
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8994
Mailing Address - Country:US
Mailing Address - Phone:252-441-1006
Mailing Address - Fax:252-441-9488
Practice Address - Street 1:2518 S CROATAN HWY STE C
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8994
Practice Address - Country:US
Practice Address - Phone:252-441-1006
Practice Address - Fax:252-441-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7304261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental