Individual
DR. ISIS EL GHANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
24795 STATE ROAD 54, LUTZ, FL 33559-6243
(813) 733-0007
Mailing address
24795 STATE ROAD 54, LUTZ, FL 33559-6243
(786) 716-1589
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN24480
FL
Other
Enumeration date
03/07/2017
Last updated
01/28/2025
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