Provider Demographics
NPI:1538120720
Name:DAVID C. HOUPT D.M.D.
Entity Type:Organization
Organization Name:DAVID C. HOUPT D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOUPT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-692-9437
Mailing Address - Street 1:8745 PACIFIC AVE NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8394
Mailing Address - Country:US
Mailing Address - Phone:360-692-9437
Mailing Address - Fax:360-698-8754
Practice Address - Street 1:8745 PACIFIC AVE NW
Practice Address - Street 2:SUITE 101
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8394
Practice Address - Country:US
Practice Address - Phone:360-692-9437
Practice Address - Fax:360-698-8754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA73671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty