Provider Demographics
NPI:1598426736
Name:MANN NORTERRA DENTAL
Entity Type:Organization
Organization Name:MANN NORTERRA DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROOPINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-378-9802
Mailing Address - Street 1:2370 W HAPPY VALLEY RD STE 1073
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8508
Mailing Address - Country:US
Mailing Address - Phone:623-780-3333
Mailing Address - Fax:
Practice Address - Street 1:2370 W HAPPY VALLEY RD STE 1073
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8508
Practice Address - Country:US
Practice Address - Phone:623-780-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty