| NPI | 1477190502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSSAM ALKHOURY Owner 508-505-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |