Provider Demographics
NPI:1841416708
Name:RAYMOND C. HAUSBECK DDS PLC
Entity Type:Organization
Organization Name:RAYMOND C. HAUSBECK DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAUSBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-799-6220
Mailing Address - Street 1:65 N FROST DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-7151
Mailing Address - Country:US
Mailing Address - Phone:989-799-6220
Mailing Address - Fax:989-790-1520
Practice Address - Street 1:65 N FROST DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-7151
Practice Address - Country:US
Practice Address - Phone:989-799-6220
Practice Address - Fax:989-790-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI09703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty