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Individual

KIRK EDWARD HOUSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD PA

Contact information

Practice address
12313 GREENVILLE HWY, LYMAN, SC 29365-1515
(864) 439-3322
(864) 949-3953
Mailing address
12313 GREENVILLE HWY, LYMAN, SC 29365-1515
(864) 439-3322
(864) 949-3953

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3598
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9592
SC
05
ZX3598
SC
Enumeration date
01/30/2008
Last updated
08/16/2022
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