Individual
DR. MICHAEL S MANSOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2401 LAWRENCEVILLE HWY STE A, LAWRENCEVILLE, GA 30044-4411
(770) 962-0014
(770) 962-9886
Mailing address
2401 LAWRENCEVILLE HWY STE A, LAWRENCEVILLE, GA 30044-4411
(770) 962-0014
(770) 962-9886
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012848
GA
Other
Enumeration date
01/31/2007
Last updated
04/11/2008
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