Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI Number | 1932611696 |
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| LBN Legal business name | PHILIP C. MANN, DDS, MD, LLC | ||||
| Authorized official | PHILIP MANN - (SOLE MEMBER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 11/02/2017 | ||||
| Last updated | 02/29/2024 - About 2 years ago | ||||
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