Individual
NICHOLAS MANIATIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
19365 7TH AVE NE STE 110, POULSBO, WA 98370-7441
(360) 697-3331
Mailing address
19365 7TH AVE NE STE 110, POULSBO, WA 98370-7441
(360) 697-3331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61239837
WA
122300000X
Dentist
Primary
DR61158552
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2021
Last updated
05/18/2026
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