Individual
MOSTAFA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS,PROSTHODONTIST
Contact information
Practice address
1 CARRIAGE CITY PLZ APT 1105, RAHWAY, NJ 07065-5185
(609) 968-8353
Mailing address
1 CARRIAGE CITY PLZ APT 1105, RAHWAY, NJ 07065-5185
(609) 968-8353
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033395
IL
122300000X
Dentist
2901601119
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019033395
—
IL
05
—
2901601119APP21
—
MI
Enumeration date
09/09/2021
Last updated
09/09/2021
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