Provider Demographics
NPI:1992778658
Name:HOURIGAN, DIANE RENAE (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:RENAE
Last Name:HOURIGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WILLOW DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7078
Mailing Address - Country:US
Mailing Address - Phone:919-967-2472
Mailing Address - Fax:919-967-2578
Practice Address - Street 1:901 WILLOW DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7078
Practice Address - Country:US
Practice Address - Phone:919-967-2472
Practice Address - Fax:919-967-2578
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC69111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice