Provider Demographics
NPI:1144457847
Name:COUET FAMILY DENTAL, INC.
Entity type:Organization
Organization Name:COUET FAMILY DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COUET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-947-1955
Mailing Address - Street 1:47 E GROVE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1816
Mailing Address - Country:US
Mailing Address - Phone:508-947-1955
Mailing Address - Fax:
Practice Address - Street 1:47 E GROVE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1816
Practice Address - Country:US
Practice Address - Phone:508-947-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13923261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental