Individual
DR. SAMY ALY MOHAMED IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS.
Contact information
Practice address
166 N MOORPARK RD, SUITE 302, THOUSAND OAKS, CA 91360-4405
(805) 497-7366
(805) 497-0638
Mailing address
166 N MOORPARK RD, SUITE 302, THOUSAND OAKS, CA 91360-4405
(805) 497-7366
(805) 497-0638
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
39815
CA
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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