Provider Demographics
NPI:1770221319
Name:HOUBBA, ANITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:HOUBBA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7434 SILVER LEAF LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3350
Mailing Address - Country:US
Mailing Address - Phone:248-444-4982
Mailing Address - Fax:
Practice Address - Street 1:6161 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2384
Practice Address - Country:US
Practice Address - Phone:248-444-4982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601399APP22122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist