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Individual

JACK KOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
6221 W PIERSON RD, FLUSHING, MI 48433-2338
(810) 733-2700
Mailing address
6221 W PIERSON RD, FLUSHING, MI 48433-2338
(810) 733-2700
(810) 733-3638

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601605
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019029583
IL
Enumeration date
05/08/2012
Last updated
03/06/2024
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