Provider Demographics
NPI:1821219759
Name:COUCH, CURTIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:COUCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32704 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5527
Mailing Address - Country:US
Mailing Address - Phone:818-879-0616
Mailing Address - Fax:
Practice Address - Street 1:7068 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2926
Practice Address - Country:US
Practice Address - Phone:818-781-1533
Practice Address - Fax:818-781-2877
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist