Individual
IRAMIS KOUROMENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1721 UNIVERSITY AVE APT#209, BERKELEY, CA 94703
(510) 323-6533
Mailing address
1721 UNIVERSITY AVE APT 209, BERKELEY, CA 94703
(510) 323-6533
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
25615
CA
126800000X
Dental Assistant
AEF885
CA
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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