Individual
MOHAMED ALI BOUKHEIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
268 MAIN ST, MADISON, NJ 07940-2269
(973) 822-8003
Mailing address
268 MAIN ST, MADISON, NJ 07940-2269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019030599
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02778000
NJ
Other
Enumeration date
03/24/2015
Last updated
03/16/2020
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