Provider Demographics
NPI:1346457223
Name:KHAN, FEROZ A (DDS)
Entity Type:Individual
Prefix:
First Name:FEROZ
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BLUESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5974
Mailing Address - Country:US
Mailing Address - Phone:636-949-5673
Mailing Address - Fax:636-949-5673
Practice Address - Street 1:2000 BLUESTONE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5974
Practice Address - Country:US
Practice Address - Phone:636-949-5673
Practice Address - Fax:636-949-5673
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0151161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice