Provider Demographics
NPI:1003664087
Name:HOUSER, JESSICA MARIE (DDS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:HOUSER
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 1:9409 SHERWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2772
Mailing Address - Country:US
Mailing Address - Phone:440-759-5480
Mailing Address - Fax:
Practice Address - Street 1:8998 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-2315
Practice Address - Country:US
Practice Address - Phone:440-546-9522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0274671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice