Individual
ADIL SHAHBAZ MOGHUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
319 NE VIVION RD, KANSAS CITY, MO 64118-4510
(816) 459-0000
Mailing address
1437 GARDENA AVE NE, FRIDLEY, MN 55432-5815
(612) 558-4069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2022017694
MO
1223G0001X
General Practice Dentistry
2022017964
MO
Other
Enumeration date
05/18/2022
Last updated
09/13/2023
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