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General NPI Number Information
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NPI Number | 1457575870
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Entity Type | Individual
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Provider Name | OLIVIA SCOTT HOUGEN DMD
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 826 CHIEF EDDIE HOFFMAN HIGHWAY
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City | BETHEL
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State | AK
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Zip | 99559
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Country | US
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Telephone | 907-543-6619
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Fax | 907-543-6393
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Provider Business Mailing Address
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Address Line | PO BOX 1696
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City | BETHEL
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State | AK
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Zip | 99559-1696
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Country | US
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Telephone | 907-543-4311
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 797
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License Number State | AK
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