Provider Demographics
NPI:1982887915
Name:HOULIHAN, JOHN F (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:HOULIHAN
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 1:2450 WOLF RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5643
Mailing Address - Country:US
Mailing Address - Phone:708-492-0300
Mailing Address - Fax:708-492-0303
Practice Address - Street 1:2450 WOLF RD
Practice Address - Street 2:SUITE B
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5643
Practice Address - Country:US
Practice Address - Phone:708-492-0300
Practice Address - Fax:708-492-0303
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist