# SHANNA COUCH HOLLIDAY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881965879
- **Authorized official:** DR. SHANNA HOLLIDAY DMD (OWNER)
- **Authorized official phone:** (606) 439-1069

## Contact information

- **Practice address:** 251 MORTON BLVD, HAZARD, KY 41701-9470
- **Practice address phone:** (606) 439-1079
- **Mailing address:** PO BOX 799, HAZARD, KY 41702-0799
- **Mailing address phone:** (606) 439-1079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7633 | KY | Yes |

## Other

- **Enumeration date:** 01/23/2012
- **Last updated:** 01/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60000262 | — | KY |