Healthcare Provider Details

I. General information

NPI: 1659583151
Provider Name (Legal Business Name): DAVID C HOU DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 MONTAUK HWY
WATER MILL NY
11976-2630
US

IV. Provider business mailing address

1308 MONTAUK HWY
WATER MILL NY
11976-2630
US

V. Phone/Fax

Practice location:
  • Phone: 631-283-0222
  • Fax: 631-287-3792
Mailing address:
  • Phone: 631-283-0222
  • Fax: 631-287-3792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number045737
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: