Individual
DR. SHAHNAZ BHARI AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
956 KEHRS MILL ROAD, BALLWIN, MO 63011
(636) 527-2779
Mailing address
956 KEHRS MILL ROAD, BALLWIN, MO 63011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
09926
IA
1223P0221X
Pediatric Dentistry
Primary
2003011674
MO
1223P0221X
Pediatric Dentistry
23366-875
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200405630
—
IN
Enumeration date
02/23/2007
Last updated
11/15/2022
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