Individual
DR. ANDREW KOUKOULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4904 19TH AVE, ASTORIA, NY 11105-1002
(718) 777-3494
Mailing address
4904 19TH AVE, ASTORIA, NY 11105-1002
(718) 777-3494
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
042427
NY
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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