Individual
MANLEY MINCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3536 RHOADS AVE, NEWTOWN SQUARE, PA 19073-3702
(610) 356-5660
(610) 356-1902
Mailing address
3536 RHOADS AVE, NEWTOWN SQUARE, PA 19073-3702
(610) 356-5660
(610) 356-1902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS021228L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
879781
UNITED CONCORDIA PROVIDER
PA
Enumeration date
03/13/2007
Last updated
07/08/2007
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