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Organization

DEAN R. HUSSONG, DDS, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEAN R HUSSONG DDS (PRESIDENT)
(715) 453-5321
Entity
Organization

Contact information

Practice address
10 BRADLEY FARM RD, TOMAHAWK, WI 54487-1563
(715) 453-5321
Mailing address
10 BRADLEY FARM RD, TOMAHAWK, WI 54487-1563
(715) 453-5321

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5002144-015
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38391200
WI
Enumeration date
04/18/2007
Last updated
08/22/2020
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