Individual
RYAN DEAN HUSSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1010 S 3RD ST STE 2A, POLK CITY, IA 50226-1181
(515) 984-6001
(515) 984-6707
Mailing address
1010 S 3RD ST STE 2A, POLK CITY, IA 50226-1181
(515) 984-6001
(515) 984-6707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08491
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080200
—
IA
Enumeration date
07/10/2007
Last updated
09/18/2012
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