Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 4327 | MD |
NPI | 1104817402 |
---|---|
Provider Name | Dr. William Roland Houck |
First Address | Easton, MD 21601 |
Second Address | Easton, MD 21601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 08/07/2007 |