Organization
HARRIS I MANN DMD LLC
Active
Other names
Harris I Mann DMD & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRIS I MANN D.M.D. (OWNER)
(215) 673-8887
Entity
Organization
Contact information
Practice address
11621 BUSTLETON AVE, PHILADELPHIA, PA 19116-2513
(215) 673-8887
(215) 673-9680
Mailing address
11621 BUSTLETON AVE, PHILADELPHIA, PA 19116-2513
(215) 673-8887
(215) 673-9680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS025302L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
447171
UCCI
PA
Enumeration date
12/05/2006
Last updated
07/16/2008
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