Provider Demographics
NPI:1669496220
Name:KHOURY, AMINE GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMINE
Middle Name:GEORGE
Last Name:KHOURY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 VALLE VERDE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2415
Mailing Address - Country:US
Mailing Address - Phone:707-265-9440
Mailing Address - Fax:707-255-4542
Practice Address - Street 1:3434 VILLA LN STE 160
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-265-9440
Practice Address - Fax:707-265-9439
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49768122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist