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Individual

DONNA MANSOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
212 N MOON AVE, BRANDON, FL 33510-4422
(813) 689-5928
Mailing address
4020 SAWYER RD, SARASOTA, FL 34233-1272
(941) 366-7475

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN24732
FL
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Enumeration date
04/15/2019
Last updated
07/26/2022
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