Provider Demographics
NPI:1013137967
Name:KORONI, ABDOUL R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABDOUL
Middle Name:R
Last Name:KORONI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 OAK HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-1767
Mailing Address - Country:US
Mailing Address - Phone:281-338-0374
Mailing Address - Fax:
Practice Address - Street 1:4023 GULF ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4723
Practice Address - Country:US
Practice Address - Phone:713-645-8822
Practice Address - Fax:713-649-6023
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice