Individual
EBRAHIM SHAFIEHA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
902 E HAMMER LANE, STOCKTON, CA 95210
(209) 957-9500
(209) 957-9508
Mailing address
4224 PINEHURST CIRCLE, STOCKTON, CA 95219
(209) 477-7507
(209) 477-7507
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
43395
CA
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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