Organization
E M KOURI DDS MSD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE M KOURI DDS,MSD (OWNER)
(817) 732-2821
Entity
Organization
Contact information
Practice address
2921 LACKLAND RD, SUITE 201, FORT WORTH, TX 76116-4173
(817) 732-2821
(817) 763-0419
Mailing address
2921 LACKLAND RD, SUITE 201, FORT WORTH, TX 76116-4173
(817) 732-2821
(817) 763-0419
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7179
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091320401
—
TX
Enumeration date
10/18/2007
Last updated
10/02/2012
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