Couch Holliday, Shanna

Couch Holliday, Shanna is an individual health care provider with primary practice located at 251 Morton Blvd , Hazard KY 41701-9470. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is her primary health care specialty. Couch Holliday, Shanna can be contacted via phone (606) 439-1079.

Contact Information

Primary practice address
251 Morton Blvd Hazard KY 41701-9470
Phone: (606) 439-1079
Fax: (606) 439-3878
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7633 Kentucky
Dental Providers / Pediatric Dentistry 1223P0221X 7633 Kentucky

Profile Details

NPI number 1508901166
LBN Legal business name Couch Holliday, Shanna
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Jul 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508901166 NPPES
Kentucky MEDICAID 60000262
Kentucky MEDICAID 45003811

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