Individual
THAWAB BARBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2006 N ROCK RD STE 300, DERBY, KS 67037-3857
(316) 416-6057
Mailing address
9911 E 21ST ST N APT 1308, WICHITA, KS 67206-3530
(708) 981-4043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
62205
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2024
Last updated
06/27/2024
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