Individual
DR. PATRICK PROCOPIO YANONG MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
ONE MAIN ST, PEABODY, MA 01960
(978) 532-2700
Mailing address
2937 WEALD ST, WHITELAND, IN 46184-9255
(312) 998-0104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1858009
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2018
Last updated
07/05/2018
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