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JOSE ENRIQUE IBANEZ-PABON DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1417094962

Individual Registrant:
 JOSE ENRIQUE IBANEZ-PABON DMD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
238 BROOKLEY AVE  BOLLING AFB, DC 20332-0701 US
Tel: 202-767-5382  Fax: 202-767-4091

Contact information for business:
5483 ASHLEIGH RD  FAIRFAX, VA 22030-7269 US
Tel: 703-681-6464  Fax: 703-681-6152

Registration Information:
NPI: 1417094962
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
OH21179

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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