Individual
CARLOS R IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1415 ROLKIN COURT, SUITE 101, CHARLOTTESVILLE, VA 22911
(434) 295-0911
(434) 295-4139
Mailing address
1415 ROLKIN COURT, SUITE 101, CHARLOTTESVILLE, VA 22911
(434) 295-0911
(434) 295-4139
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401412224
VA
Other
Enumeration date
06/24/2005
Last updated
10/17/2018
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