Provider Demographics
NPI:1801255914
Name:ROJELIO A MANCIAS DENTIST INC
Entity type:Organization
Organization Name:ROJELIO A MANCIAS DENTIST INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROJELIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANCIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-775-0150
Mailing Address - Street 1:1033 E ALISAL ST STE H
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2700
Mailing Address - Country:US
Mailing Address - Phone:831-775-0150
Mailing Address - Fax:831-775-0154
Practice Address - Street 1:1033 E ALISAL ST STE H
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2700
Practice Address - Country:US
Practice Address - Phone:831-775-0150
Practice Address - Fax:831-775-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty