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Organization

GULF FAMILY DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ABDOUL R KORONI DDS (PRESIDENT)
(713) 946-8200
Entity
Organization

Contact information

Practice address
3701 SHAVER ST, PASADENA, TX 77504-2601
(713) 946-8200
(713) 946-8203
Mailing address
3701 SHAVER ST., PASADENA, TX 77504
(713) 946-8200
(713) 946-8203

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19896
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0078305-02
TX
05
0078305-04
TX
Enumeration date
02/23/2015
Last updated
02/23/2015
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