Individual
ANDY KOULTOURIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
619 RIDGE ROAD, MUNSTER, IN 46321
(219) 836-1111
(219) 836-1410
Mailing address
619 RIDGE ROAD, MUNSTER, IN 46321
(219) 836-1111
(219) 836-1410
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12009245
IN
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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