DR. Ikechukwu P. Ebo, D.D.S., P.A.

NPI #1093880288 in Lawrenceville, Georgia

Provider Information

NPI Number: 1093880288
Entity Type: Individual
Name: DR. Ikechukwu P. Ebo, D.D.S., P.A.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S., P.A.
Enumeration Date: Nov 22, 2006
Last Updated: Jul 1, 2011

Practice Location

Address: 650 GWINNETT DR
City: Lawrenceville
State: Georgia
ZIP Code: 30046-7439
Phone: (770) 963-5999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - General Practice — General Practice	1223G0001X

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