Individual
DR. LEROY DOUGLAS COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
107 BRENTWOOD PL, CORBIN, KY 40701
(606) 528-5600
(606) 528-5604
Mailing address
107 BRENTWOOD PLACE, CORBIN, KY 40701
(606) 528-5600
(606) 528-5604
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7855
KY
1223G0001X
General Practice Dentistry
7855
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003092
—
KY
Enumeration date
01/08/2007
Last updated
03/27/2008
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