Provider Demographics
NPI:1861639106
Name:MANNING, HENRY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:MANNING
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 1:11920 PERKINS RD
Mailing Address - Street 2:STE. A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0800
Mailing Address - Country:US
Mailing Address - Phone:225-767-3130
Mailing Address - Fax:225-767-3994
Practice Address - Street 1:11920 PERKINS RD
Practice Address - Street 2:STE. A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-0800
Practice Address - Country:US
Practice Address - Phone:225-767-3130
Practice Address - Fax:225-767-3994
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist