Individual
DR. TARA ELIZABETH HABIBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3422 UTAH ST FL 2, SAINT LOUIS, MO 63118-2727
(217) 415-7408
Mailing address
3422 UTAH ST FL 2, SAINT LOUIS, MO 63118-2727
(217) 415-7408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032737
IL
122300000X
Dentist
2020019181
MO
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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