Individual
SHADZI JEBRAEILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS, ORTHO CERT.
Contact information
Practice address
8210 FLOYD CURL DR, SAN ANTONIO, TX 78229-3923
(210) 450-3500
Mailing address
18 BEAVERBROOK CRESCENT, MAPLE, ONTARIO L6A3T-2
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
31669
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
31669
TX
Other
Enumeration date
06/04/2018
Last updated
10/21/2020
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