Individual
MONA RIZK IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MPH, MS
Contact information
Practice address
DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX, 1151 TAYLOR STREET, 7TH FLOOR PEDIATRIC DENTAL CLINIC, DETROIT, MI 48202-1732
(313) 876-4087
(313) 871-1589
Mailing address
DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX, 1151 TAYLOR STREET, 7TH FLOOR PEDIATRIC DENTAL CLINIC, DETROIT, MI 48202-1732
(313) 876-4087
(313) 871-1589
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3191980
—
MI
Enumeration date
03/09/2007
Last updated
07/08/2007
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