Healthcare Provider Details

I. General information

NPI: 1427135383
Provider Name (Legal Business Name): CLAUDE JEAN GHARIB DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1269 W 13 MILE RD
MADISON HGTS MI
48071
US

IV. Provider business mailing address

2412 MELDRUM RD
WINDSOR ONTARIO
N8W4E8
CA

V. Phone/Fax

Practice location:
  • Phone: 248-588-8105
  • Fax:
Mailing address:
  • Phone: 519-945-0977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901019434
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: