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Individual

DR. PETER T. KOUSOULIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
501 SOUTH 4TH STREET, PHILADELPHIA, PA 19147
(215) 925-7299
(215) 925-4108
Mailing address
501 S 4TH ST, PHILADELPHIA, PA 19147
(215) 925-7299
(215) 924-4108

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS027559L
PA

Other

Enumeration date
07/11/2006
Last updated
07/08/2007
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