Individual
MRS. KELLY EATON MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
7520 W WASHINGTON AVE, SUITE 120, LAS VEGAS, NV 89128-4330
(702) 363-1590
Mailing address
10737 WOODLORE PL, LAS VEGAS, NV 89144-5401
(702) 314-8670
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
101165
NV
Other
Enumeration date
01/28/2007
Last updated
07/08/2007
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