Individual
TRES HOBSON MANASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
27695 U.S. HWY 98, DAPHNE, AL 36526
(251) 626-8480
Mailing address
PO BOX 967, DAPHNE, AL 36526-0967
(251) 626-8480
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
4718
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00867
BCBS OF AL
AL
Enumeration date
08/29/2006
Last updated
07/08/2007
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