Provider Demographics
NPI:1801999396
Name:GHALY, HANY IBRAHIM (DDS)
Entity type:Individual
Prefix:
First Name:HANY
Middle Name:IBRAHIM
Last Name:GHALY
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 1:552 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324
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:COLTON VALLEY DENTAL
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-825-7123
Practice Address - Fax:909-825-8758
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist