Individual
JOSE ENRIQUE IBANEZ-PABON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
238 BROOKLEY AVE, BOLLING AFB, DC 20332-0701
(202) 767-5382
(202) 767-4091
Mailing address
5483 ASHLEIGH RD, FAIRFAX, VA 22030-7269
(703) 681-6464
(703) 681-6152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21179
OH
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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