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Individual

SHIVA KHATAMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-7500
(954) 262-7164
Mailing address
110 N FEDERAL HWY, APT # 813, FT LAUDERDALE, FL 33301-1180
(954) 632-7884

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DTP533
FL

Other

Enumeration date
11/29/2010
Last updated
11/29/2010
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