Individual
CATHERINE ALEXANDRA KOUBEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 N MAIN ST, WILLISTON, FL 32696-1705
(352) 528-2447
(352) 755-3078
Mailing address
919 NW 42ND TER, GAINESVILLE, FL 32605-4767
(321) 917-8234
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN22911
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2017
Last updated
10/11/2018
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