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Organization
HOUSKA DENTAL CLINIC
Active
Organization
HOUSKA DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY HOUSKA DDS (OWNER/DENTIST)
(605) 624-3031
Entity
Organization
Contact information
Practice address
1302 E MAIN ST, VERMILLION, SD 57069-2813
(605) 624-3031
(605) 624-8084
Mailing address
1302 E MAIN ST, VERMILLION, SD 57069-2813
(605) 624-3031
(605) 624-8084
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
M724
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805970
—
SD
Enumeration date
06/17/2011
Last updated
06/17/2011
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