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Individual

DR. TYRA MANSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
31 VALLEY RD, 2ND FLOOR, MONTCLAIR, NJ 07042-2708
(973) 771-5387
Mailing address
31 VALLEY RD, 2ND FLOOR, MONTCLAIR, NJ 07042-2708
(973) 771-5387

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
0539911
NY
1223P0221X
Pediatric Dentistry
Primary
22DI023814
NJ

Other

Enumeration date
07/29/2008
Last updated
06/02/2016
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