| Organization Name: | HOUSKA DENTAL CLINIC |
| NPI Number: | 1053606053 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDY HOUSKA (OWNER/DENTIST) |
| Mailing Address: | 1302 E Main St Vermillion |
| State: | SD US |
| Postal Code: | 570692813 |
| Phone Number: | 6056243031 |
| Fax Number: | 6056248084 |
| NPI Enumeration Date: | 06/17/2011 |
| NPI Last Update Date: | 06/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | M724 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |