Provider Demographics
NPI:1700019213
Name:MANSPERGER, CYRIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:
Last Name:MANSPERGER
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 1:535 ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508
Mailing Address - Country:US
Mailing Address - Phone:845-831-3435
Mailing Address - Fax:845-831-3437
Practice Address - Street 1:535 ROUTE 52
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508
Practice Address - Country:US
Practice Address - Phone:845-831-3435
Practice Address - Fax:845-831-3437
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14346122300000X
NY035981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist