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General NPI Number Information
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NPI Number | 1396369054
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Entity Type | Individual
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Provider Name | JOHN THOMAS HOUSTON IV DDS, MSD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 125 COOL SPRINGS BLVD # 140
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City | FRANKLIN
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State | TN
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Zip | 37067-6474
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Country | US
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Telephone | 615-771-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 700 12TH AVE S UNIT 1107
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City | NASHVILLE
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State | TN
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Zip | 37203-3431
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Country | US
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Telephone | 214-980-3328
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 33533
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License Number State | TX
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