| E M Kouri Dds Msd Pllc | |
|
2921 Lackland Rd Suite 201 Fort Worth TX 76116-4173 | |
| (817) 732-2821 | |
| (817) 763-0419 |
| Full Name | E M Kouri Dds Msd Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2921 Lackland Rd, Fort Worth, Texas |
| Authorized Official Name and Position | Eugene M Kouri (OWNER) |
| Authorized Official Contact | 8177322821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E M Kouri Dds Msd Pllc 2921 Lackland Rd Suite 201 Fort Worth TX 76116-4173 Ph: (817) 732-2821 | E M Kouri Dds Msd Pllc 2921 Lackland Rd Suite 201 Fort Worth TX 76116-4173 Ph: (817) 732-2821 |
| NPI Number | 1144419821 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 10/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144419821 | NPI | - | NPPES |
| 091320401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7179 (Texas) | Primary |
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