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Individual

BILAL IBRAHIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-4697
Mailing address
6475 KENILWORTH ST, DEARBORN, MI 48126-2158

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021.003447
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901600887
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
NONE OBTAINED
MI
Enumeration date
07/04/2020
Last updated
09/02/2025
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