Provider Demographics
NPI:1477055457
Name:STEPHANIE C. MANNING, DDS, PA
Entity type:Organization
Organization Name:STEPHANIE C. MANNING, DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-699-3293
Mailing Address - Street 1:PO BOX 690477
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7008
Mailing Address - Country:US
Mailing Address - Phone:704-699-3293
Mailing Address - Fax:
Practice Address - Street 1:7322 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7594
Practice Address - Country:US
Practice Address - Phone:704-699-3293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHANIE C. MANNING, DDS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-06
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC8390261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental