Individual
SHIVAM PARBHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3719 MADISON AVE, KANSAS CITY, MO 64111-3813
(314) 550-3005
Mailing address
3719 MADISON AVE, KANSAS CITY, MO 64111-3813
(314) 550-3005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018003191
MO
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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