Individual
SHANA K KHAMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2001 W BETHANY HOME RD, PHOENIX, AZ 85015-2471
(602) 249-9621
(602) 841-1916
Mailing address
9617 KENNETH AVE, SKOKIE, IL 60076-1203
(847) 542-9316
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010852
AZ
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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