Provider Demographics
NPI:1629401146
Name:MANZOOR, NOUSHEEN BAIG (DMD)
Entity Type:Individual
Prefix:DR
First Name:NOUSHEEN
Middle Name:BAIG
Last Name:MANZOOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 LANDERBROOK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6509
Mailing Address - Country:US
Mailing Address - Phone:440-446-1555
Mailing Address - Fax:440-446-1990
Practice Address - Street 1:5800 LANDERBROOK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6509
Practice Address - Country:US
Practice Address - Phone:440-446-1555
Practice Address - Fax:440-446-1990
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0240641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice