Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 31410 | TX |
NPI | 1023482429 |
---|---|
Provider Name | Mohamed Kar-Kuri |
First Address | Dallas, TX 75207-3308 |
Second Address | Dallas, TX 75219-2551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2015 |
Last Update Date | 25/11/2015 |