Provider Demographics
NPI:1568541498
Name:KHOURY, SAMER (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:
Last Name:KHOURY
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 NEWTOWN YARDLEY RD
Mailing Address - Street 2:#1C
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1758
Mailing Address - Country:US
Mailing Address - Phone:215-968-9601
Mailing Address - Fax:
Practice Address - Street 1:638 NEWTOWN YARDLEY RD
Practice Address - Street 2:#1C
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1758
Practice Address - Country:US
Practice Address - Phone:215-968-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0374201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics