Provider Demographics
NPI:1912070079
Name:DIANE R. HOURIGAN, DDS, PA
Entity Type:Organization
Organization Name:DIANE R. HOURIGAN, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:HOURIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-967-2472
Mailing Address - Street 1:901 WILLOW DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7078
Mailing Address - Country:US
Mailing Address - Phone:919-967-2472
Mailing Address - Fax:919-967-2578
Practice Address - Street 1:901 WILLOW DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7078
Practice Address - Country:US
Practice Address - Phone:919-967-2472
Practice Address - Fax:919-967-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC69111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty