Individual
DR. TIMOTHY MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3554 W GLENDALE AVE, PHOENIX, AZ 85051-8358
(602) 233-5665
Mailing address
8309SWMAIN ST 100, WILSONVILLE, OR 97070-6598
(503) 682-0550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D7174
AZ
1223G0001X
General Practice Dentistry
Primary
D9694
OR
1223G0001X
General Practice Dentistry
DE00010805
WA
Other
Enumeration date
03/07/2007
Last updated
06/18/2020
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