Individual
DR. COREY MENOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1830 E BROAD ST STE 104, MANSFIELD, TX 76063-9161
(817) 473-7171
(817) 473-2594
Mailing address
1830 E BROAD ST STE 104, MANSFIELD, TX 76063-9161
(817) 473-7171
(817) 473-2594
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
34681
TX
Other
Enumeration date
03/13/2017
Last updated
12/11/2019
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