Individual
ELISABETH T KOUSOULIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7922 W CHESTER PIKE, UPPER DARBY, PA 19082-1917
(610) 853-4350
(610) 853-4312
Mailing address
7922 W CHESTER PIKE, UPPER DARBY, PA 19082-1917
(610) 853-4350
(610) 853-4312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS020859L
PA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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