Individual
OMAR HMS MOUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MSC, MS, FRCDC
Contact information
Practice address
501 S PRESTON ST OFC 58, LOUISVILLE, KY 40202-1701
(614) 886-7609
Mailing address
501 S PRESTON ST OFC 68, LOUISVILLE, KY 40202-1701
(614) 886-7609
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11169
KY
1223P0700X
Prosthodontics
Primary
1214
KY
Other
Enumeration date
09/12/2024
Last updated
09/13/2024
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