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Individual

DR. GIANCARLO COUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
777 E PARK AVE, CHIPPEWA FALLS, WI 54729-3508
(715) 723-0366
Mailing address
1340 W FILLMORE ST, CHICAGO, IL 60607-4807
(929) 229-6445

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001102
WI
1223G0001X
General Practice Dentistry
2019037298
MO

Other

Enumeration date
10/30/2019
Last updated
12/29/2022
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