Individual
DR. CLYDE PHILIP HOUSTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1220 MARK AVE, TOMAH, WI 54660-1199
(608) 372-4455
Mailing address
1220 MARK AVE, TOMAH, WI 54660-1199
(608) 372-4455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2815
WI
Other
Enumeration date
03/31/2006
Last updated
07/08/2007
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