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Individual
DR. BRUCE DAVID HUSTAD
Active
Individual
DR. BRUCE DAVID HUSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7814
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008116
PREFERRED ONE
MN
01
—
401549
UNITED CONCORDIA
MN
01
—
41594HU
BCBS MN
MN
01
—
HP37187
HEALTH PARTNERS
MN
Enumeration date
09/21/2006
Last updated
10/30/2007
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