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General NPI Number Information
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NPI Number | 1043440068
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Entity Type | Individual
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Provider Name | MICHAEL HOUSTON WASSON DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 10250 N 92ND ST STE 301
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4520
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Country | US
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Telephone | 480-896-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 10250 N 92ND ST STE 301
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4520
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Country | US
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Telephone | 480-896-0600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D011165
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24806
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DR60213519
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DE6048933
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License Number State | WA
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