Individual
MR. AZIZ JABBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
474 STATE RTE 3, PLATTSBURGH, NY 12901
(518) 566-6400
(518) 566-8479
Mailing address
474 STATE RTE 3, PLATTSBURGH, NY 12901
(518) 566-6400
(518) 566-8479
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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