Provider Demographics
NPI:1982022745
Name:GHARRAPH,PC
Entity Type:Organization
Organization Name:GHARRAPH,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:GHARRAPH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-709-8822
Mailing Address - Street 1:4609 GARDENIA WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7093
Mailing Address - Country:US
Mailing Address - Phone:909-709-8822
Mailing Address - Fax:
Practice Address - Street 1:3851 SW GREEN OAK BLVD
Practice Address - Street 2:123
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4130
Practice Address - Country:US
Practice Address - Phone:817-483-2445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-30
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty