Individual
DR. KELLY MICHAEL HUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
415 E MAIN ST, OTTUMWA, IA 52501-3027
(641) 684-0215
Mailing address
322 E PARK AVE APT 2, OTTUMWA, IA 52501-2069
(319) 610-3505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08922
IA
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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