Provider Demographics
NPI:1699826305
Name:MANZUR, LAMYA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:LAMYA
Middle Name:
Last Name:MANZUR
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 1:20335 OLD CUTLER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1800
Mailing Address - Country:US
Mailing Address - Phone:305-238-6777
Mailing Address - Fax:
Practice Address - Street 1:20335 OLD CUTLER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189-1800
Practice Address - Country:US
Practice Address - Phone:305-238-6777
Practice Address - Fax:305-253-4055
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN152021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice