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General NPI Number Information
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NPI Number | 1063965614
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Entity Type | Individual
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Provider Name | NATALIA C HABIBI DMD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 810 OFALLON RD STE 80
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City | WELDON SPRING
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State | MO
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Zip | 63304-8107
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Country | US
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Telephone | 636-244-4052
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Fax |
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Provider Business Mailing Address
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Address Line | 810 OFALLON RD STE 80
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City | WELDON SPRING
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State | MO
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Zip | 63304-8107
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Country | US
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Telephone | 636-244-4052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2017012882
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859245
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019030912
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License Number State | IL
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