Individual
MR. AZIZ JABBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062781
NY
1223G0001X
General Practice Dentistry
062781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061058
LICENSE NUMBER NYS
NY
Enumeration date
09/29/2022
Last updated
04/03/2023
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