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1598754947
MOHAMMED MANSOORUL IMAM
ELMHURST, NY
NPI
1598754947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 049149)
Enumeration Date
2005-10-18
Last Update Date
2010-11-12
Business Address
Dr. MOHAMMED MANSOORUL IMAM DDS
5611 94TH ST SUITE # LN
ELMHURST, NY 11373-5080
Phone number: 718-271-4424
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Mailing Address
Dr. MOHAMMED MANSOORUL IMAM DDS
5611 94TH ST SUITE # LN
ELMHURST, NY 11373-5080
Phone number: 718-271-4424
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