Provider Demographics
NPI:1720306301
Name:ALMUNIF, IBRAHIM ALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:ALI
Last Name:ALMUNIF
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 1:1658 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2879
Mailing Address - Country:US
Mailing Address - Phone:574-217-6128
Mailing Address - Fax:
Practice Address - Street 1:1658 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2879
Practice Address - Country:US
Practice Address - Phone:574-217-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2011-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist