Provider Demographics
NPI:1306850680
Name:HOUK, NICHOLAS LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:LLOYD
Last Name:HOUK
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 1:196 S. MCCLEARY RD
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-1183
Mailing Address - Country:US
Mailing Address - Phone:816-630-5713
Mailing Address - Fax:816-630-0392
Practice Address - Street 1:196 S. MCCLEARY RD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-1183
Practice Address - Country:US
Practice Address - Phone:816-630-5713
Practice Address - Fax:816-630-0392
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0120831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice