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Individual

DR. JOHN B GOUCH SR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3616 MICHIGAN AVE, CHARLOTTE, NC 28215
(704) 537-6636
(704) 537-5005
Mailing address
3616 MICHIGAN AVE, CHARLOTTE, NC 28215
(704) 537-6636
(704) 537-5005

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3922
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8993292
NC
Enumeration date
03/24/2006
Last updated
07/08/2007
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