El Mofty, Samir Khattab

El Mofty, Samir Khattab is an individual health care provider with primary practice located at 425 S Euclid Ave 3Rd Floor, Saint Louis MO 63110-1005. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. El Mofty, Samir Khattab can be contacted via phone (314) 362-5641.

Contact Information

Primary practice address
425 S Euclid Ave 3Rd Floor Saint Louis MO 63110-1005
Phone: (314) 362-5641
Fax: (314) 362-0369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 014731 Missouri

Profile Details

NPI number 1558387878
LBN Legal business name El Mofty, Samir Khattab
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Oct 23rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558387878 NPPES
Missouri MEDICAID 019010176

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