Organization
BULLARD DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANDANA KOUROSHNIA DDS (PRESIDENT)
(559) 439-9990
Entity
Organization
Contact information
Practice address
323 E BULLARD AVE, SUITE 104, FRESNO, CA 93710-5213
(559) 439-9990
(559) 439-9996
Mailing address
323 E BULLARD AVE, SUITE 104, FRESNO, CA 93710-5213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/03/2008
Last updated
09/04/2008
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