Individual
DR. BRUCE DAVID HUSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1225 E 1ST ST, DULUTH, MN 55805-2402
(218) 728-6445
(218) 724-7003
Mailing address
1225 E 1ST ST, DULUTH, MN 55805-2402
(218) 728-6445
(218) 724-7003
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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