Individual
DR. MATTHEW MANIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031126
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2016
Last updated
03/13/2025
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