Provider Demographics
NPI:1831982941
Name:HAUGHTON, OWAYNE (DMD)
Entity type:Individual
Prefix:DR
First Name:OWAYNE
Middle Name:
Last Name:HAUGHTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12523 SW MYRTLE OAK DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-6410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12523 SW MYRTLE OAK DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-6410
Practice Address - Country:US
Practice Address - Phone:954-274-9647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-09-25
Deactivation Date:2025-07-22
Deactivation Code:
Reactivation Date:2025-09-10
Provider Licenses
StateLicense IDTaxonomies
FLDN30799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist