Provider Demographics
NPI:1366545717
Name:MANKOVSKIY, KONSTANTIN V (DDS)
Entity type:Individual
Prefix:DR
First Name:KONSTANTIN
Middle Name:V
Last Name:MANKOVSKIY
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 1:19 LONGFELLOW TER
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1464
Mailing Address - Country:US
Mailing Address - Phone:732-617-2688
Mailing Address - Fax:
Practice Address - Street 1:19 LONGFELLOW TER
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1464
Practice Address - Country:US
Practice Address - Phone:732-617-2688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20671122300000X
NY046068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist