| Ibrahim Dental Corporation | |
|
25880 Tournament Rd Suite 103 Valencia CA 91355-2349 | |
| (661) 294-3700 | |
| (661) 294-9080 |
| Full Name | Ibrahim Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 25880 Tournament Rd, Valencia, California |
| Authorized Official Name and Position | Enitan Cassandra Ibrahim (PRESIDENT) |
| Authorized Official Contact | 6612943700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ibrahim Dental Corporation 23642 Lyons Ave #220465 Newhall CA 91322-6001 Ph: (661) 294-3700 | Ibrahim Dental Corporation 25880 Tournament Rd Suite 103 Valencia CA 91355-2349 Ph: (661) 294-3700 |
| NPI Number | 1720323371 |
|---|---|
| Provider Enumeration Date | 12/09/2012 |
| Last Update Date | 12/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720323371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 50613 (California) | Primary |
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