Individual
DR. REZA MOVAHED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1585 WOODLAKE DR STE 208, CHESTERFIELD, MO 63017-5740
(314) 878-6725
(314) 878-6726
Mailing address
1585 WOODLAKE DR, SUITE 208, ST. LOUIS, MO 63141
(314) 878-6725
(314) 878-6726
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002639
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2013024987
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013024987
LICENSE NUMBER
MO
Enumeration date
02/04/2009
Last updated
06/05/2023
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