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General NPI Number Information
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NPI Number | 1467519819
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Entity Type | Organization
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Legal Business Name | CHESLEY R HOUSKE JR., DDS, INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 W CARSON ST
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City | CARSON
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State | CA
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Zip | 90745-2608
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Country | US
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Telephone | 310-787-7053
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Fax | 310-787-8182
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Provider Business Mailing Address
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Address Line | 27401 EASTVALE RD
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-4018
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Country | US
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Telephone | 310-787-7053
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Fax | 310-787-8182
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELOISA TAPIA
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Credential |
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Telephone | 310-787-7053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32425
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License Number State | CA
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