Manor Dental Center P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

00347Y Issued in MI

Legal business name

MANOR DENTAL CENTER P.C.

Practice address

10645 W Warren Ave
Suite 100
Dearborn, MI 48126-1540

Phone

(313) 582-3340

Fax

(313) 582-3339

NPI assigned

Oct 22, 2007

Last updated

Oct 22, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alex I Awwad

Title

Owner

Phone

(313) 727-7227

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1942499322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 W WARREN AVE",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261540",
            "telephone_number": "313-582-3340",
            "fax_number": "313-582-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 W WARREN AVE",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261540",
            "telephone_number": "313-582-3340",
            "fax_number": "313-582-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR DENTAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "AWWAD",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-727-7227",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "00347Y",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mancini Consulting L.L.C.
• Peter Mancini II, M.D.
• Alicia Kay Mandeville
• Rebecca Ann Mandzak, PHARMD
• Georgeta Banica Manitiu
• Manor Medical Center PC
• Manor Urdent Care 1
• Manor Urgent Care PC
• Manor Urgent Care, PC
• Manuel Alexander Manrique, PH.D., L.P.

• Dentist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.