Individual
DR. GAVIN SHIBLI TARAZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11941 MANCHESTER RD, DES PERES, MO 63131-4502
(314) 501-8300
Mailing address
303 E 3RD ST APT A, ALTON, IL 62002-2407
(815) 382-7291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2025036865
MO
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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