Individual
JOANN CAPOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
80
ND
Other
Enumeration date
12/18/2025
Last updated
12/18/2025
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