Provider Demographics
NPI:1881748465
Name:HUSKEY, DAVID RAYMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAYMOND
Last Name:HUSKEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 EGLIN ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-9644
Mailing Address - Country:US
Mailing Address - Phone:605-877-3798
Mailing Address - Fax:
Practice Address - Street 1:1147 EGLIN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-9644
Practice Address - Country:US
Practice Address - Phone:605-877-3798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM5981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice