Provider Demographics
NPI:1811225345
Name:HOUPT, DAVID C (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:HOUPT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 PACIFIC AVE NW STE 101
Mailing Address - Street 2:
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 STE 101
Practice Address - Street 2:
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
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7367122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist