Provider Demographics
NPI:1891192597
Name:COUCH AND HAMMOND DENTISTRY PARTNERSHIP
Entity type:Organization
Organization Name:COUCH AND HAMMOND DENTISTRY PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BART
Authorized Official - Last Name:COUCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:530-677-0723
Mailing Address - Street 1:970 CAMERADO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7636
Mailing Address - Country:US
Mailing Address - Phone:530-677-0723
Mailing Address - Fax:530-677-0723
Practice Address - Street 1:970 CAMERADO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7636
Practice Address - Country:US
Practice Address - Phone:530-677-0723
Practice Address - Fax:530-677-0723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty