Provider Demographics
NPI:1649398660
Name:GHOBRIAL, JOSEPH NABIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NABIL
Last Name:GHOBRIAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 REGAL LILY LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5526
Mailing Address - Country:US
Mailing Address - Phone:925-736-6658
Mailing Address - Fax:
Practice Address - Street 1:3432 HILLCREST AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8238
Practice Address - Country:US
Practice Address - Phone:925-736-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice