Individual
FARES MUSSAD ALSHURAIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1114 WASHINGTON ST, WATERTOWN, NY 13601-4353
(315) 788-0122
Mailing address
1331 MOUNT HOPE AVE APT 303, ROCHESTER, NY 14620-3934
(585) 957-1184
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
063262
NY
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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