Provider Demographics
NPI:1073815411
Name:KAMEL, HIBA (DMD)
Entity Type:Individual
Prefix:DR
First Name:HIBA
Middle Name:
Last Name:KAMEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HIBA
Other - Middle Name:
Other - Last Name:SAFAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:9378 OLIVE BLVD
Mailing Address - Street 2:SUITE 1LL
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3215
Mailing Address - Country:US
Mailing Address - Phone:314-872-3930
Mailing Address - Fax:314-872-3952
Practice Address - Street 1:9378 OLIVE BLVD
Practice Address - Street 2:SUITE 1LL
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-3215
Practice Address - Country:US
Practice Address - Phone:314-872-3930
Practice Address - Fax:314-872-3952
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist