# AAVA DENTAL OF FOOTHILL RANCH A MANSOUR DENTAL GROUP INC RODEO MANAGEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AAVA DENTAL OF FOOTHILL RANCH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679906895
- **Authorized official:** YAHYA MANSOUR DDS (OWNER)
- **Authorized official phone:** (817) 529-8151

## Contact information

- **Practice address:** 27462 PORTOLA PKWY, STE 205, FOOTHILL RANCH, CA 92610-2838
- **Practice address phone:** (817) 529-8151
- **Practice address fax:** (817) 529-8156
- **Mailing address:** 27462 PORTOLA PKWY, STE 205, FOOTHILL RANCH, CA 92610-2838
- **Mailing address phone:** (817) 529-8151
- **Mailing address fax:** (817) 529-8156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 58012 | CA | Yes |

## Other

- **Enumeration date:** 08/12/2013
- **Last updated:** 08/12/2013