Provider Demographics
NPI:1184722902
Name:MANHARD, MICHAEL FRANCIS (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:MANHARD
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 1:3144 EL CAMINO REAL STE 204
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2194
Mailing Address - Country:US
Mailing Address - Phone:760-434-7144
Mailing Address - Fax:760-434-8144
Practice Address - Street 1:3750 ROHNERVILLE RD
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-3118
Practice Address - Country:US
Practice Address - Phone:707-617-2555
Practice Address - Fax:707-725-7843
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist