Provider Demographics
NPI:1205942588
Name:HOUSER, JUDITH BALTAZAR ZANTUA (DDS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:BALTAZAR ZANTUA
Last Name:HOUSER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:BALTAZAR
Other - Last Name:ZANTUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:18920 BOTHELL WAY NE STE 200
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1981
Mailing Address - Country:US
Mailing Address - Phone:425-483-5838
Mailing Address - Fax:
Practice Address - Street 1:18920 BOTHELL WAY NE STE 200
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1981
Practice Address - Country:US
Practice Address - Phone:425-483-5838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist