Provider Demographics
NPI:1235481847
Name:HOUGHTON, DAVID ROBERT
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:HOUGHTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAVE
Other - Middle Name:
Other - Last Name:HOUGHTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:503 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4007
Mailing Address - Country:US
Mailing Address - Phone:727-467-5541
Mailing Address - Fax:
Practice Address - Street 1:503 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4007
Practice Address - Country:US
Practice Address - Phone:727-467-5541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL141861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice