Individual
DR. KEVIN SCOTT MANZELLA
Active
Individual
DR. KEVIN SCOTT MANZELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
059107-1
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
059107-1
NY
Other
Enumeration date
08/08/2017
Last updated
03/17/2018
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