Provider Demographics
NPI:1700238490
Name:MANTERIS, WILLIAM ARTHUR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:MANTERIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 MCKNIGHT RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3414
Mailing Address - Country:US
Mailing Address - Phone:412-366-6900
Mailing Address - Fax:
Practice Address - Street 1:4725 MCKNIGHT RD
Practice Address - Street 2:SUITE 211
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3414
Practice Address - Country:US
Practice Address - Phone:412-366-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019075L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist