# RAMI A KHOURY DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902263916
- **Authorized official:** DR. RAMI A KHOURY DMD (OWNER)
- **Authorized official phone:** (610) 691-3311

## Contact information

- **Practice address:** 1003 BROADWAY, FOUNTAIN HILL, PA 18015-4101
- **Practice address phone:** (610) 691-3311
- **Practice address fax:** (610) 317-6052
- **Mailing address:** 1003 BROADWAY, BETHLEHEM, PA 18015
- **Mailing address phone:** (610) 691-3311
- **Mailing address fax:** (610) 317-6052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS035891 | PA | Yes |

## Other

- **Enumeration date:** 01/21/2016
- **Last updated:** 01/21/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 101874749 0001 | — | PA |
| 01 | — | 1215069752 | INDIVIDUAL NPI | — |