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General NPI Number Information
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NPI Number | 1083087423
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Entity Type | Organization
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Legal Business Name | SIMPLY ORTHODONTICS, NH, PC
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 49 DERRY ST
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City | HUDSON
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State | NH
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Zip | 03051-4027
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Country | US
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Telephone | 603-889-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 49 DERRY ST
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City | HUDSON
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State | NH
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Zip | 03051-4027
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Country | US
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Telephone | 603-889-1100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOUSSAM ALKHOURY
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Credential |
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Telephone | 603-889-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 03377
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License Number State | NH
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