Organization
MANSKE DENTAL CORPORATION
Active
Other names
Mouthrover
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA LYNN MANSKE DDS (CEO)
(424) 354-9336
Entity
Organization
Contact information
Practice address
445 N ALFRED ST, LOS ANGELES, CA 90048-2504
(424) 354-9336
(424) 322-4781
Mailing address
1355 N SIERRA BONITA AVE APT 302, WEST HOLLYWOOD, CA 90046-8518
(424) 354-9336
(424) 322-4781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
59357
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083926323
—
CA
Enumeration date
03/24/2015
Last updated
08/02/2024
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