Individual
DR. JAIRUS HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1220 MARK AVE, TOMAH, WI 54660-1199
(608) 372-4455
(608) 372-6105
Mailing address
1220 MARK AVE, TOMAH, WI 54660-1199
(608) 372-4455
(608) 372-6105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001002-15
WI
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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