Organization
TIMBERLAND DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY HUGER HOUSTON III DDS (PRESIDENT/OWNER)
(251) 580-0979
Entity
Organization
Contact information
Practice address
301 E 1ST ST, BAY MINETTE, AL 36507-4029
(251) 580-0979
(251) 580-0971
Mailing address
301 E 1ST ST, BAY MINETTE, AL 36507-4029
(251) 580-0979
(251) 580-0971
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5114
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009931835
—
AL
01
—
515-38527
BC/BS
AL
Enumeration date
09/29/2010
Last updated
09/29/2010
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