Provider Demographics
NPI:1982810545
Name:MANERI, JOSEPH MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:MANERI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AUSTIN CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4584
Mailing Address - Country:US
Mailing Address - Phone:732-928-4096
Mailing Address - Fax:
Practice Address - Street 1:75 LACEY RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2938
Practice Address - Country:US
Practice Address - Phone:732-350-2100
Practice Address - Fax:732-350-1152
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015171001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice