Provider Demographics
NPI:1134156615
Name:MANN, CHARLES ASHLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ASHLEY
Last Name:MANN
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 1:315 E. CHATHAM ST.
Mailing Address - Street 2:STE. 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-462-9338
Mailing Address - Fax:919-462-9386
Practice Address - Street 1:315 E CHATHAM ST
Practice Address - Street 2:STE. 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3472
Practice Address - Country:US
Practice Address - Phone:919-462-9338
Practice Address - Fax:919-462-9386
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7007NC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice