Provider Demographics
NPI:1154504033
Name:HOUCHINS, NATHAN SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:SCOTT
Last Name:HOUCHINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 TAZEWELL ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2348
Mailing Address - Country:US
Mailing Address - Phone:276-223-0006
Mailing Address - Fax:276-223-0008
Practice Address - Street 1:190 TAZEWELL ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2348
Practice Address - Country:US
Practice Address - Phone:276-223-0006
Practice Address - Fax:276-223-0008
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014119541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice