# LOUAY MANSOUR DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437761400
- **Authorized official:** MR. LOUAY MANSOUR DDS (OWNER)
- **Authorized official phone:** (586) 445-2990

## Contact information

- **Practice address:** 27845 GRATIOT AVENUE, ROSEVILLE, MI 48066
- **Practice address phone:** (586) 455-2990
- **Mailing address:** 27845 GRATOIT AVE., ROSEVILLE, MI 48066
- **Mailing address phone:** (568) 445-2990
- **Mailing address fax:** (586) 445-2991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2020
- **Last updated:** 10/13/2020