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General NPI Number Information
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NPI Number | 1447318910
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Entity Type | Individual
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Provider Name | JOHN HASSAN KHOURI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 14535 JOHN MARSHALL HWY. SUITE 111
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City | GAINESVILLE
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State | VA
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Zip | 20155
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Country | US
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Telephone | 571-248-4262
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Fax | 571-248-4265
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Provider Business Mailing Address
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Address Line | 14535 JOHN MARSHALL HWY SUITE 111
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City | GAINESVILLE
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State | VA
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Zip | 20155
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Country | US
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Telephone | 571-248-4262
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Fax | 571-248-4265
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401410341
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License Number State | VA
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