Organization
DR GREOGRY G MANNING PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GENE MANNING DDS (PRESIDENT)
(919) 258-9811
Entity
Organization
Contact information
Practice address
105 CHURCH ST, 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
—
013AV
BCBS
—
05
—
013AV
—
NC
Enumeration date
12/05/2006
Last updated
08/22/2020
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