Provider Demographics
NPI:1134504798
Name:HANY IBRAHIM GHALY DDS, INC.
Entity Type:Organization
Organization Name:HANY IBRAHIM GHALY DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANY
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:GHALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-825-7123
Mailing Address - Street 1:552 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2249
Mailing Address - Country:US
Mailing Address - Phone:909-825-7123
Mailing Address - Fax:909-825-8758
Practice Address - Street 1:552 W VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2249
Practice Address - Country:US
Practice Address - Phone:909-825-7123
Practice Address - Fax:909-825-8758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA380001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty