Provider Demographics
NPI:1033736681
Name:HOUSTON, MICHELLE LONATI (DMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LONATI
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HOSIERY MILL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1687
Mailing Address - Country:US
Mailing Address - Phone:770-445-1314
Mailing Address - Fax:
Practice Address - Street 1:49 HOSIERY MILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1687
Practice Address - Country:US
Practice Address - Phone:770-445-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0160861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice