Individual
DR. SAMIR KHATTAB EL MOFTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
425 S EUCLID AVE, 3RD FLOOR, SAINT LOUIS, MO 63110-1005
(314) 362-5641
(314) 362-0369
Mailing address
4253 CLAYTON AVE, CB 8118, SAINT LOUIS, MO 63110
(314) 362-5641
(314) 362-0369
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
014731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019010176
—
MO
Enumeration date
07/14/2006
Last updated
10/23/2015
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