| NPI | 1093352585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSSAM ALKHOURY Owner 508-505-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |