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Organization
GEORGE KOUTSOUKOS DDS, INC
Active
Organization
GEORGE KOUTSOUKOS DDS, INC
Active
Other names
Elite Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KON KOUTSOUKOS D.D.S (OWNER)
(661) 222-7724
Entity
Organization
Contact information
Practice address
24155 MAGIC MOUNTAIN PKWY, VALENCIA, CA 91355-3904
(661) 222-7724
(661) 222-7464
Mailing address
24155 MAGIC MOUNTAIN PKWY, VALENCIA, CA 91355-3904
(661) 222-7724
(661) 222-7464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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