Healthcare Provider Details

I. General information

NPI: 1801057344
Provider Name (Legal Business Name): WILLIAM R. HOUCK, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 DUTCHMANS LN
EASTON MD
21601-3345
US

IV. Provider business mailing address

613 DUTCHMANS LN
EASTON MD
21601-3345
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-7575
  • Fax: 410-763-8929
Mailing address:
  • Phone: 410-822-7575
  • Fax: 410-763-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4327
License Number StateMD

VIII. Authorized Official

Name: WILLIAM ROLAND HOUCK
Title or Position: OWNER
Credential:
Phone: 410-822-7575