| NPI | 1891331468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSSAM ALKHOURY Owner 508-505-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2023-03-13 |