Provider Demographics
NPI:1255062055
Name:BUTCHCOE, HOUSTON (DDS)
Entity type:Individual
Prefix:DR
First Name:HOUSTON
Middle Name:
Last Name:BUTCHCOE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 STEILACOOM BLVD SW STE 202
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-4773
Mailing Address - Country:US
Mailing Address - Phone:253-584-6200
Mailing Address - Fax:
Practice Address - Street 1:8520 STEILACOOM BLVD SW STE 202
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-4773
Practice Address - Country:US
Practice Address - Phone:253-584-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE612938661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice