Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | MA20511 | MA |
NPI | 1043403769 |
---|---|
Provider Name | Dr. Houssam Alkhoury |
First Address | Worcester, MA 01609 |
Second Address | Worcester, MA 01609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 27/08/2007 |