| NPI | 1073611810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM ALKHOURY Owner 508-757-3173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 20511) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |