Organization
MANNEM & ASSOCIATES, INC
Active
Other names
Lakeway Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
SASI K MANNEM DDS (OWNER)
(512) 402-9090
Entity
Organization
Contact information
Practice address
3315 RR 620 S, SUITE 250, LAKEWAY, TX 78738-6867
(512) 402-9090
Mailing address
3315 RR 620 S, SUITE 250, LAKEWAY, TX 78738-6867
(512) 402-9090
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
19578
TX
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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