Organization
IBRAHIM-SMILEKEEPERS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESSAM N IBRAHIM DDS (OWNER)
(410) 766-2221
Entity
Organization
Contact information
Practice address
7954 BALTIMORE ANNAPOLIS BLVD, SUITE 1-C, GLEN BURNIE, MD 21060-8188
(410) 766-2221
Mailing address
PO BOX 550, GLEN BURNIE, MD 21060-0550
(410) 766-2221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11627
MD
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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