Provider Demographics
NPI:1063432722
Name:MANESS, PAUL FRANKLIN (DDS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANKLIN
Last Name:MANESS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 SIX FORKS ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-847-8074
Mailing Address - Fax:919-847-8173
Practice Address - Street 1:5900 SIX FORKS ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-847-8074
Practice Address - Fax:919-847-8173
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC46621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7995459Medicaid