Provider Demographics
NPI:1275243933
Name:KEVIN S. HUELSMAN, DDS, LLC
Entity Type:Organization
Organization Name:KEVIN S. HUELSMAN, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUELSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-885-8785
Mailing Address - Street 1:862 PROPRIETORS RD STE A
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3331
Mailing Address - Country:US
Mailing Address - Phone:614-885-8785
Mailing Address - Fax:614-825-6290
Practice Address - Street 1:862 PROPRIETORS RD STE A
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3331
Practice Address - Country:US
Practice Address - Phone:614-885-8785
Practice Address - Fax:614-825-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty