Provider Demographics
NPI:1902060239
Name:ORTHODONTIC ASSOCIATES OF NORTON, LLC
Entity Type:Organization
Organization Name:ORTHODONTIC ASSOCIATES OF NORTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOUSSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-285-4001
Mailing Address - Street 1:108 W MAIN ST
Mailing Address - Street 2:SUITE #1-A
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1248
Mailing Address - Country:US
Mailing Address - Phone:508-285-4001
Mailing Address - Fax:
Practice Address - Street 1:108 W MAIN ST
Practice Address - Street 2:SUITE #1-A
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1248
Practice Address - Country:US
Practice Address - Phone:508-285-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA20511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty