Individual
DR. KENNETH PAUL MANNING II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
2403 CHARLES BLVD, GREENVILLE, NC 27858-5925
(252) 756-3333
(252) 756-1397
Mailing address
2403 CHARLES BLVD, GREENVILLE, NC 27858-5925
(252) 756-3333
(252) 756-1397
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6697
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9004R
BCBS
NC
Enumeration date
02/25/2008
Last updated
02/25/2008
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