Individual
MARY ELMASRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 343-6562
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013843A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12013843A
INDIANA STATE LICENSE
IN
Enumeration date
07/09/2022
Last updated
05/05/2026
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