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General NPI Number Information
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NPI Number | 1922894815
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Entity Type | Individual
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Provider Name | GEORGE AL KHOURI RDH
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Gender | Male
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 269 UNION ST
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City | LYNN
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State | MA
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Zip | 01901-1314
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Country | US
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Telephone | 947-205-8157
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Fax |
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Provider Business Mailing Address
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Address Line | 1876 HEMPSTEAD DR
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City | TROY
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State | MI
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Zip | 48083-2633
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Country | US
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Telephone | 947-205-8157
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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