Individual
DR. MICHAEL JOSEPH MANGINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
408 S 28TH ST, SUITE A, PADUCAH, KY 42003-3808
(270) 444-4041
(270) 444-7319
Mailing address
408 S 28TH ST, SUITE A, PADUCAH, KY 42003-3808
(270) 444-4041
(270) 444-7319
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12011881A
IN
1223G0001X
General Practice Dentistry
30023551
OH
1223G0001X
General Practice Dentistry
Primary
9145
KY
Other
Enumeration date
08/22/2011
Last updated
03/01/2016
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