Individual
DR. DANIEL BRUCE MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1107 INDIAN MOUND DR STE C, MT STERLING, KY 40353-1300
(859) 498-2356
(859) 498-2413
Mailing address
PO BOX 520, MT STERLING, KY 40353-0520
(859) 498-2356
(859) 498-2413
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5357
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45003688
MEDICAID EPSDT
KY
Enumeration date
09/10/2007
Last updated
09/10/2007
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