Provider Demographics
NPI:1598890667
Name:RICHARD F. KOUP D.M.D. & ASSOCIATES LLC
Entity Type:Organization
Organization Name:RICHARD F. KOUP D.M.D. & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:KOUP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-644-0408
Mailing Address - Street 1:325 CENTRAL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3219
Mailing Address - Country:US
Mailing Address - Phone:610-644-0408
Mailing Address - Fax:610-647-1024
Practice Address - Street 1:325 CENTRAL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3219
Practice Address - Country:US
Practice Address - Phone:610-644-0408
Practice Address - Fax:610-647-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018758L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty