Individual
DR. MOHAMED IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MS, PHD, DMD
Contact information
Practice address
1250 W WISCONSIN AVE, MILWAUKEE, WI 53233-2225
(414) 288-3455
Mailing address
18320 TAYWOOD CIR APT 202, BROOKFIELD, WI 53045-5681
(319) 512-2837
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
18061-875
WI
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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