Organization
MANSOURI DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MANSOURI DMD (DENTIST/OWNER)
(267) 441-2565
Entity
Organization
Contact information
Practice address
2401 LAWRENCEVILLE HWY STE A, LAWRENCEVILLE, GA 30044-4669
(678) 909-1970
Mailing address
2401 LAWRENCEVILLE HWY STE A, LAWRENCEVILLE, GA 30044-4669
(678) 909-1970
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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