Organization
INGERSOLL DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY ANDREW KOURI D.D.S. (PARTNER)
(515) 274-5151
Entity
Organization
Contact information
Practice address
3830 INGERSOLL AVE, DES MOINES, IA 50312-3413
(515) 274-5151
(515) 274-6259
Mailing address
3830 INGERSOLL AVE, DES MOINES, IA 50312-3413
(515) 274-5151
(515) 274-6259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08239
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1480590
—
IA
05
—
1481259
—
IA
Enumeration date
09/05/2007
Last updated
09/05/2007
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