Organization
SOUTHBRIDGE BRACES PC
Active
Other names
Super Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOUSSAM ALKHOURY DMD (PRESIDENT)
(508) 505-5040
Entity
Organization
Contact information
Practice address
39 ELM ST, SUITE 301, SOUTHBRIDGE, MA 01550-2644
(508) 909-6719
Mailing address
87 ELM ST, THIRD FLOOR, HOPKINTON, MA 01748-1638
(508) 589-8270
(508) 319-3339
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN20511
MA
Other
Enumeration date
02/13/2017
Last updated
05/17/2021
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