Organization
COSMETIC FAMILY & IMPLANT DENTISTRY OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S MANSOURI DMD (DENTIST/OWNER)
(267) 441-2565
Entity
Organization
Contact information
Practice address
3350 RIVERWOOD PKWY SE, SUITE 2120, ATLANTA, GA 30339-6401
(770) 955-2505
(770) 953-4011
Mailing address
3350 RIVERWOOD PKWY SE, SUITE 2120, ATLANTA, GA 30339-6401
(770) 955-2505
(770) 953-4011
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
DN012848
GA
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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