Provider Demographics
NPI:1831306869
Name:MANN, GEORGE R JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:MANN
Suffix:JR
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 1:15 KIEL AVE.
Mailing Address - Street 2:SUITE #202
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405
Mailing Address - Country:US
Mailing Address - Phone:973-492-1670
Mailing Address - Fax:
Practice Address - Street 1:15 KIEL AVENUE
Practice Address - Street 2:SUITE #202
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405
Practice Address - Country:US
Practice Address - Phone:973-492-1670
Practice Address - Fax:973-838-0913
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1009777001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice