Provider Demographics
NPI:1457906539
Name:MANNING DENTAL LLC
Entity Type:Organization
Organization Name:MANNING DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-579-5730
Mailing Address - Street 1:717 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1007
Mailing Address - Country:US
Mailing Address - Phone:712-655-4040
Mailing Address - Fax:
Practice Address - Street 1:717 3RD ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1007
Practice Address - Country:US
Practice Address - Phone:712-655-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental