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General NPI Number Information
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NPI Number | 1053660670
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Entity Type | Individual
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Provider Name | NAWRAS AL-KHOURY D.M.D
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Gender | Male
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 2482 WONDER DR FRIENDLY DENTAL
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City | KANNAPOLIS
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State | NC
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Zip | 28083-6427
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Country | US
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Telephone | 704-786-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 2482 WONDER DR FRIENDLY DENTAL
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City | KANNAPOLIS
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State | NC
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Zip | 28083-6427
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Country | US
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Telephone | 704-786-7007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9342
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License Number State | NC
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