Individual
DR. PHILIPPE MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3740 SOUTH 14TH ST, JOINT BASE LEWIS-MCCHORD, WA 98433
(253) 967-5271
Mailing address
1341 DUKES CREEK DR NW, KENNESAW, GA 30152-8232
(404) 769-0216
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN016045
GA
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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