Individual
OMAR IBRAHIM RAGAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2429 ELLSWORTH RD, YPSILANTI, MI 48197-4853
(734) 434-0043
Mailing address
3464 HONEYSUCKLE CT, ANN ARBOR, MI 48103-8856
(201) 515-0296
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901022368
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901022368
MICHIGAN PROFESSION AND LICENSE
MI
Enumeration date
06/27/2017
Last updated
06/27/2017
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