Provider Demographics
NPI:1700949708
Name:HOUGHT, ROMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:
Last Name:HOUGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3450 PENROSE PL
Mailing Address - Street 2:SUITE #120
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1828
Mailing Address - Country:US
Mailing Address - Phone:303-447-9735
Mailing Address - Fax:303-447-1025
Practice Address - Street 1:3450 PENROSE PL
Practice Address - Street 2:SUITE #120
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1828
Practice Address - Country:US
Practice Address - Phone:303-447-9735
Practice Address - Fax:303-447-1025
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO08351223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology