Individual
OLIVIA MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
105 CHURCH ST, BROADWAY, NC 27505-9394
(919) 258-9811
Mailing address
PO BOX 69, BROADWAY, NC 27505-0069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13720
NC
Other
Enumeration date
05/17/2023
Last updated
06/05/2024
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