Individual
ALEXANDER KHALIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1540 BEACON ST, BROOKLINE, MA 02446-2215
(781) 414-0495
Mailing address
238 LENOX ST, NORWOOD, MA 02062-3435
(781) 414-0495
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
DA14036
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA14036
MASSACHUSETTS BOARD OF DENTISTRY
MA
Enumeration date
04/28/2022
Last updated
04/28/2022
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