Individual
SHABNAM MOHAMMED CHARLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8215
Mailing address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8215
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
390200000X
TX
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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