Khazoum, George

Khazoum, George is an sole proprietor health care provider with primary practice located at 1905 Convenience Pl Ste A , Champaign IL 61820-8927. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Khazoum, George can be contacted via phone (217) 355-5165.

Contact Information

Primary practice address
1905 Convenience Pl Ste A Champaign IL 61820-8927
Phone: (217) 355-5165
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 22897 Florida
Dental Providers / General Practice 1223G0001X 019.031429 Illinois
Dental Providers / General Practice 1223G0001X 22897 Florida
Dental Providers / Dentist 122300000X 019.031429 Illinois

Profile Details

NPI number 1669994232
LBN Legal business name Khazoum, George
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2017
Last updated Apr 21st, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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