Provider Demographics
NPI:1134311673
Name:JUMANA GHORAB, DDS, PC
Entity Type:Organization
Organization Name:JUMANA GHORAB, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHORAB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-545-0724
Mailing Address - Street 1:2550 E GUADALUPE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5114
Mailing Address - Country:US
Mailing Address - Phone:480-545-0724
Mailing Address - Fax:480-545-0743
Practice Address - Street 1:2550 E GUADALUPE RD STE 105
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5114
Practice Address - Country:US
Practice Address - Phone:480-545-0724
Practice Address - Fax:480-545-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty