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Individual

DR. KHALED Y. SHABANY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
443 N NEW BALLAS RD STE 244, CREVE COEUR, MO 63141-6800
(314) 755-1542
(314) 755-1546
Mailing address
2049 MCKELVEY RD, MARYLAND HEIGHTS, MO 63043-2307
(314) 878-2111
(314) 878-7648

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2002003037
MO
1223P0300X
Periodontics
021.001930
IL
1223P0300X
Periodontics
Primary
2002003037
MO

Other

Enumeration date
11/21/2006
Last updated
01/20/2023
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