Individual
DR. RICHARD C MANUS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1360 CADUCEUS WAY, BUILDING 500 SUITE 101, WATKINSVILLE, GA 30677
(706) 548-0604
(706) 353-0884
Mailing address
1360 CADUCEUS WAY, BUILDING 500 SUITE 101, WATKINSVILLE, GA 30677
(706) 548-0604
(706) 353-0884
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
010412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52472462-002
BLUE CROSS BLUE SHIELD
GA
Enumeration date
03/12/2007
Last updated
05/15/2019
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