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Organization
JOHN D MANCINI DDS PC
Active
Organization
JOHN D MANCINI DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D MANCINI (PRESIDENT)
(269) 651-6345
Entity
Organization
Contact information
Practice address
1415 S LAKEVIEW AVE, STURGIS, MI 49091-2350
(269) 651-6345
Mailing address
1415 S LAKEVIEW AVE, STURGIS, MI 49091-2350
(269) 651-6345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P05230001
MEDICARE IDENTIFICATION NUMBER (PTAN)
MI
Enumeration date
10/13/2016
Last updated
10/13/2016
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