Individual
DR. IBRAHIM KHATIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MPROS
Contact information
Practice address
1801 W WISCONSIN AVE OFC 327, MILWAUKEE, WI 53233-2186
(414) 288-6047
Mailing address
5805 N LYDELL AVE #308, GLENDALE, WI 53217
(262) 227-5585
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
23475-875
WI
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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