Individual
DIANA TABAKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12927 STATE LINE RD, KANSAS CITY, MO 64145-1238
(816) 942-7669
(816) 942-7808
Mailing address
12927 STATE LINE RD, KANSAS CITY, MO 64145-1238
(816) 942-7669
(816) 942-7808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016135
MO
Other
Enumeration date
02/18/2007
Last updated
07/08/2007
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