Individual
GHULAM MAKHDOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
640 W KARSCH BLVD, FARMINGTON, MO 63640-3342
(573) 705-3485
Mailing address
1235 ASSUMPTION DR, SAINT LOUIS, MO 63125-4668
(618) 203-2772
(618) 203-2772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025028404
MO
Other
Enumeration date
07/10/2025
Last updated
07/17/2025
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