Provider Demographics
NPI:1932333788
Name:PAUL R. MANN, D.D.S., P.C.
Entity Type:Organization
Organization Name:PAUL R. MANN, D.D.S., P.C.
Other - Org Name:FOCUS ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-322-7668
Mailing Address - Street 1:1286 W FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8300
Mailing Address - Country:US
Mailing Address - Phone:816-322-7668
Mailing Address - Fax:816-322-7672
Practice Address - Street 1:1286 W FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8300
Practice Address - Country:US
Practice Address - Phone:816-322-7668
Practice Address - Fax:816-322-7672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0147101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty