Individual
JOHN KENNETH GRUSPE MANALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15920 S RANCHO SAHUARITA BLVD STE 100, SAHUARITA, AZ 85629-8013
(520) 838-0600
Mailing address
1404 N BLUE SAHUARO TRL, TUCSON, AZ 85715-5248
(520) 248-2763
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012515
AZ
Other
Enumeration date
05/23/2025
Last updated
06/02/2025
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