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Individual

DR. AYA MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
29100 LAKE SHORE BLVD, WILLOWICK, OH 44095-4659
(812) 706-9795
Mailing address
38080 TAMARAC BLVD APT 206, WILLOUGHBY, OH 44094-3446
(812) 706-9795

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019035024
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30.027686
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
40742
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN25100
FL

Other

Enumeration date
07/01/2024
Last updated
09/08/2025
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