Organization
CHARLES KHOURY, DMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES KHOURY DMD (PRESIDENT)
(508) 997-7776
Entity
Organization
Contact information
Practice address
404 HUTTLESTON AVE, 1ST FLOOR, FAIRHAVEN, MA 02719
(508) 997-7776
Mailing address
1428 DARTMOUTH WOODS DRIVE, DARTMOUTH, MA 02747
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20015
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X12286
BCBS OF MA
MA
Enumeration date
10/11/2006
Last updated
08/22/2020
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