Provider Demographics
NPI:1285268995
Name:MANOLIS THANASAS DDS PLC
Entity type:Organization
Organization Name:MANOLIS THANASAS DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANOLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:THANASAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-689-9012
Mailing Address - Street 1:4780 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4929
Mailing Address - Country:US
Mailing Address - Phone:248-689-9012
Mailing Address - Fax:
Practice Address - Street 1:4780 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-4929
Practice Address - Country:US
Practice Address - Phone:248-689-9012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service