Provider Demographics
NPI:1982943510
Name:REAMS, DOUGLAS HOUSTON (DDS)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:HOUSTON
Last Name:REAMS
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:PO BOX 1134
Mailing Address - Street 2:6075 EAST HIGHWAY 20
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-1134
Mailing Address - Country:US
Mailing Address - Phone:707-274-6605
Mailing Address - Fax:707-274-8227
Practice Address - Street 1:6075 EAST HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458
Practice Address - Country:US
Practice Address - Phone:707-274-6605
Practice Address - Fax:707-274-8227
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26910122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist