Organization
DR WILLIAM LEE HUSKEY DDS, VILLAGE GREEN DENTAL PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LEE HUSKEY DDS (OWNER)
(937) 492-7080
Entity
Organization
Contact information
Practice address
2150 WAPAKONETA AVE, SIDNEY, OH 45365-1444
(937) 492-7080
(937) 492-7046
Mailing address
2150 WAPAKONETA AVE, SIDNEY, OH 45365-1444
(937) 492-7080
(937) 492-7046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-18974
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0781079
—
OH
01
—
219583462026
CARESOURCE
—
01
—
341644055-00
WORKERS COMPENSATION
OH
01
—
598741
DELTA INSURANCE
—
Enumeration date
05/09/2007
Last updated
08/22/2020
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