Organization · Type 2 NPI

Dental Implant & Periodontal Surgeons of Maine Line, P.c.

Periodontics · Chadds Ford, PA

NPI number 1477003531 Active

Practice location

107 Commons Ct
Chadds Ford, PA 19317

Specialties and licenses

Taxonomy	Code	License
Periodontics Primary	1223P0300X	DS037420 (PA)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

NPI record

NPI: 1477003531
Entity type: Organization (Type 2)
Issued: Oct 12, 2016
Last updated: Jul 18, 2018
Status: Active

Other names

<unavail>
Sam B. Khoury, D.d.s., M.s. · doing business as
Sam B. Khoury, D.d.s., M.s. · doing business as

Authorized official

Dr. Samer B Khoury, DDS, M.S.
Periodontist
(610) 500-0610

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1477003531

Dental Implant & Periodontal Surgeons of Maine Line, P.c.'s National Provider Identifier is 1477003531, issued on Oct 12, 2016. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Chadds Ford, PA. The record was last updated on Jul 18, 2018.