Individual
DR. MANEESH MOHAN
Active
Individual
DR. MANEESH MOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12011030A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8191
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
8181
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200872180
—
IN
05
—
204E0000X
—
KY
01
—
50007575
PASSPORT
KY
05
—
6411381400
—
KY
01
—
9179239
DORAL
KY
Enumeration date
10/14/2005
Last updated
06/12/2014
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