Provider Demographics
NPI:1083013536
Name:REBECCA S. HUSER, DDS PROFESSIONAL LLC
Entity Type:Organization
Organization Name:REBECCA S. HUSER, DDS PROFESSIONAL LLC
Other - Org Name:TAMARAC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-773-1211
Mailing Address - Street 1:7555 E HAMPDEN AVE # 425
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7555 E HAMPDEN AVE # 425
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4830
Practice Address - Country:US
Practice Address - Phone:303-773-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9288122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty