Individual
DR. MOHAMED M ELGHANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
220 W BRAMBLETON AVE STE 111, NORFOLK, VA 23510-1571
(757) 583-1536
(757) 583-3470
Mailing address
220 W BRAMBLETON AVE STE 111, NORFOLK, VA 23510-1571
(757) 583-1536
(757) 583-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401417740
VA
Other
Enumeration date
07/13/2020
Last updated
03/06/2022
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