Provider Demographics
NPI:1396475653
Name:HOULIK FAMILY DENTISTRY
Entity type:Organization
Organization Name:HOULIK FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOULIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-644-0669
Mailing Address - Street 1:910 N CYPRESS CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4013
Mailing Address - Country:US
Mailing Address - Phone:316-644-0669
Mailing Address - Fax:
Practice Address - Street 1:1901 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3415
Practice Address - Country:US
Practice Address - Phone:316-685-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty