Provider Demographics
NPI:1215198221
Name:MCDONALD AND MANUS LLP
Entity type:Organization
Organization Name:MCDONALD AND MANUS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCDONALD JR.
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-548-0604
Mailing Address - Street 1:1010 PRINCE AVE
Mailing Address - Street 2:SUITE 103 SOUTH
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5805
Mailing Address - Country:US
Mailing Address - Phone:706-548-0604
Mailing Address - Fax:
Practice Address - Street 1:1010 PRINCE AVE
Practice Address - Street 2:SUITE 103 SOUTH
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5805
Practice Address - Country:US
Practice Address - Phone:706-548-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty