Most Relevant Information
Provider Data
| NPI Number: | 1003361973 |
| Provider Name: | THERESA MANRIQUE DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DN22251 |
Most Important Dates
| Enumeration Date: | 08/22/2016 |
| Last Updated: | 02/27/2018 |
Provider Practice Location
31806 BLYTHEWOOD WAY
WESLEY CHAPEL
FL
335438153
Practice Location Phone/Fax
| Phone: | 8133251153 |
| Fax: |
Provider Mailing Location
ARDENNES ROAD
FORT BRAGG
NC
283100001
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |