Organization
MANN FORTUNA DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHAM DEEP KAUR (CEO)
(510) 378-9802
Entity
Organization
Contact information
Practice address
11231 COMMERCIAL CENTER LOOP STE 105, YUMA, AZ 85367-7474
(928) 783-8300
Mailing address
11231 COMMERCIAL CENTER LOOP STE 105, YUMA, AZ 85367-7474
(928) 783-8300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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