Individual provider · Type 1 NPI

Masoud Mansouri

Student in an Organized Health Care Education/Training Program · Fort Bragg, NC

NPI number 1124948641 Active

Practice location

Dental Clinic, 4349 Gruber Rd
Fort Bragg, NC 28310

Call (910) 907-7698 Map

Mailing address

2817 Rock Merritt Ave
Fort Bragg, NC 28310

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1124948641

Masoud Mansouri's National Provider Identifier is 1124948641, issued on Jul 16, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Bragg, NC. The record was last updated on Jul 16, 2026.