Individual
DR. EMILY BARBARA KOUFOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Contact information
Practice address
1734 45TH ST, MUNSTER, IN 46321-3915
(219) 924-1440
Mailing address
9110 ELMWOOD DR, MUNSTER, IN 46321-3112
(219) 688-8949
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12013598A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12013598A
DENTAL
IN
Enumeration date
08/25/2021
Last updated
08/25/2021
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