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Individual

DR. RAFAT M MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1010 BRIDGE BLVD SW, SUITE E, ALBUQUERQUE, NM 87105-3765
(505) 877-0435
Mailing address
1010 BRIDGE BLVD SW, SUITE E, ALBUQUERQUE, NM 87105-3765

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2103
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1002823
NM
Enumeration date
10/21/2005
Last updated
05/25/2011
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