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General NPI Number Information
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NPI Number | 1740146166
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Entity Type | Individual
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Provider Name | ALEXANDER ABBOUD DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 4981 W GENESEE ST
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City | CAMILLUS
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State | NY
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Zip | 13031-2313
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Country | US
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Telephone | 315-487-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 34 GLENNIE DRIVE
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City | AJAX
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State | ONTARIO
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Zip | L1T5A4
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Country | CA
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 065276
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License Number State | NY
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