Provider Demographics
NPI:1346255627
Name:MANLEY, JOHN KENDALL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KENDALL
Last Name:MANLEY
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 1:417 BILTMORE AVE
Mailing Address - Street 2:SUITE 2-F
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4543
Mailing Address - Country:US
Mailing Address - Phone:828-253-5878
Mailing Address - Fax:
Practice Address - Street 1:417 BILTMORE AVE
Practice Address - Street 2:SUITE 2-F
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4543
Practice Address - Country:US
Practice Address - Phone:828-253-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice