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General NPI Number Information
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NPI Number | 1144457847
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Entity Type | Organization
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Legal Business Name | COUET FAMILY DENTAL, INC.
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 47 E GROVE ST SUITE 201
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City | MIDDLEBORO
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State | MA
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Zip | 02346-1816
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Country | US
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Telephone | 508-947-1955
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Fax |
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Provider Business Mailing Address
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Address Line | 47 E GROVE ST SUITE 201
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City | MIDDLEBORO
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State | MA
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Zip | 02346-1816
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Country | US
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Telephone | 508-947-1955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN ROBERT COUET
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Credential | DDS
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Telephone | 508-947-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13923
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License Number State | MA
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