Provider Demographics
NPI:1245366574
Name:HBOUS, MAHMOUD NASSER (DDS)
Entity type:Individual
Prefix:DR
First Name:MAHMOUD
Middle Name:NASSER
Last Name:HBOUS
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:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-0405
Mailing Address - Country:US
Mailing Address - Phone:315-346-1814
Mailing Address - Fax:
Practice Address - Street 1:9536 STATE RT 126
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:NY
Practice Address - Zip Code:13305
Practice Address - Country:US
Practice Address - Phone:315-346-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047844-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice