Konatham Haribabu, Prashanth

Konatham Haribabu, Prashanth is an sole proprietor health care provider with primary practice located at 1500 Park Ave Oral Maxillofacial Surgery, St Louis MO 63104-3024. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Konatham Haribabu, Prashanth can be contacted via phone (146) 853-5793.

Contact Information

Primary practice address
1500 Park Ave Oral Maxillofacial Surgery St Louis MO 63104-3024
Phone: (146) 853-5793
Fax: (314) 588-8437
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2901021748 Michigan
Dental Providers / Dentist 122300000X 2018032931 Missouri

Profile Details

NPI number 1811317142
LBN Legal business name Konatham Haribabu, Prashanth
Credentials DDS, BDS, MDS, MSD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2014
Last updated Oct 3rd, 2019 - about 5 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 1811317142 NPPES
Missouri MEDICAID 14339940

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