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General NPI Number Information
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NPI Number | 1841416708
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Entity Type | Organization
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Legal Business Name | RAYMOND C. HAUSBECK DDS PLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 65 N FROST DR
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City | SAGINAW
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State | MI
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Zip | 48638-7151
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Country | US
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Telephone | 989-799-6220
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Fax | 989-790-1520
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Provider Business Mailing Address
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Address Line | 65 N FROST DR
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City | SAGINAW
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State | MI
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Zip | 48638-7151
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Country | US
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Telephone | 989-799-6220
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Fax | 989-790-1520
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RAYMOND C HAUSBECK
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Credential | DDS
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Telephone | 989-799-6220
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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 | 09703
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License Number State | MI
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