| NPI | 1932615499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSSAM ALKHOURY Owner 508-589-8270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA DN20511) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |