Provider Demographics
NPI:1598976482
Name:HUSTER, EDWARD F (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:F
Last Name:HUSTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 BIRCH ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2247
Mailing Address - Country:US
Mailing Address - Phone:949-833-3756
Mailing Address - Fax:949-752-5124
Practice Address - Street 1:3920 BIRCH ST
Practice Address - Street 2:SUITE #101
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2247
Practice Address - Country:US
Practice Address - Phone:949-833-3756
Practice Address - Fax:949-752-5124
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist