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Individual

KHALDOUN F AL-AJLOUNI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS PA

Contact information

Practice address
100 W SOUTHLAKE BLVD, STE 146, SOUTHLAKE, TX 76092-6100
(817) 251-9333
(817) 251-9320
Mailing address
100 W SOUTHLAKE BLVD, STE 146, SOUTHLAKE, TX 76092-6100
(817) 251-9333
(817) 251-9320

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
22403
TX
1223P0700X
Prosthodontics
22403
IL
1223P0700X
Prosthodontics
Primary
22403
TX

Other

Enumeration date
07/17/2008
Last updated
05/22/2019
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