Individual
SHENOUDA IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4244 BROAD HILL DR UNIT A, HENRICO, VA 23233-7819
(551) 358-6111
Mailing address
4244 BROAD HILL DR UNIT A, HENRICO, VA 23233-7819
(551) 358-6111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418916
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2024
Last updated
06/27/2024
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