Provider Demographics
NPI:1780805127
Name:LAMANNA, ABBEY MACH (DDS)
Entity type:Individual
Prefix:DR
First Name:ABBEY
Middle Name:MACH
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 S GRAYLOG LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-2921
Mailing Address - Country:US
Mailing Address - Phone:262-786-0915
Mailing Address - Fax:
Practice Address - Street 1:2305 SILVERNAIL RD
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-5402
Practice Address - Country:US
Practice Address - Phone:262-548-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI59160151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice