Provider Demographics
NPI:1659459352
Name:MANHART, MARK JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOSEPH
Last Name:MANHART
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 1:7836 WAKELEY PLZ
Mailing Address - Street 2:MORGAN MEDICAL & PROFESSIONAL PLAZA
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3650
Mailing Address - Country:US
Mailing Address - Phone:402-391-7888
Mailing Address - Fax:402-391-2267
Practice Address - Street 1:7836 WAKELEY PLZ
Practice Address - Street 2:MORGAN MEDICAL & PROFESSIONAL PLAZA
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3650
Practice Address - Country:US
Practice Address - Phone:402-391-7888
Practice Address - Fax:402-391-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE35901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice