Individual
DR. MOHAMED SHADY MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
123 N 13TH ST, ALLENTOWN, PA 18102-3758
(773) 459-6783
Mailing address
505 WELL SWEEP RD, WHITEHOUSE STATION, NJ 08889-3250
(773) 459-6783
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22DI02509300
NJ
1223G0001X
General Practice Dentistry
Primary
DS039173
PA
Other
Enumeration date
08/29/2012
Last updated
01/11/2020
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