Provider Demographics
NPI:1760445217
Name:DENTAL ASSOCIATES OF MANHATTAN
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF MANHATTAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-539-7401
Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:BUILDING D, SUITE 202
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-539-7401
Mailing Address - Fax:
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:BUILDING D, SUITE 202
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-539-7401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5871122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty