Individual
DR. GIOVANNI IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
330 ORCHARD ST, NEW HAVEN, CT 06511
(203) 789-3156
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-9503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2.012180-RES
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2.012180-RES
CT
Other
Enumeration date
05/15/2018
Last updated
06/04/2018
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