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General NPI Number Information
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NPI Number | 1821294984
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Entity Type | Organization
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Legal Business Name | CHANEY, COUCH & ASSOCIATES
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 3612 AUSTIN DAVIS AVE
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7401
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Country | US
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Telephone | 850-877-0215
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Fax | 850-329-2642
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Provider Business Mailing Address
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Address Line | 3612 AUSTIN DAVIS AVE
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7401
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Country | US
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Telephone | 850-877-0215
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Fax | 850-329-2642
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGELA KAYE HOLLIFIELD
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Credential |
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Telephone | 850-877-0215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN8129
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN16145
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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