Individual
GREGORY GENE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 CHURCH STREET, BROADWAY, NC 27505
(919) 258-9811
(919) 258-5204
Mailing address
PO BOX 69, BROADWAY, NC 27505
(919) 258-9811
(919) 258-5204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6361
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9008V
BCBS
—
05
—
9008V
—
NC
Enumeration date
11/06/2006
Last updated
07/08/2007
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