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Organization
ORAL SURGERY CENTER OF BISMARCK, PC
Active
Organization
ORAL SURGERY CENTER OF BISMARCK, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANSUREH S IRAVANI DMD, MD (OWNER)
(701) 221-2719
Entity
Organization
Contact information
Practice address
3117 N 14TH ST, BISMARCK, ND 58503-0664
(701) 221-2719
(701) 221-2819
Mailing address
3117 N 14TH ST, BISMARCK, ND 58503-0664
(701) 221-2719
(701) 221-2819
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1928
ND
Other
Enumeration date
03/04/2008
Last updated
04/14/2014
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