Provider Demographics
NPI:1982842639
Name:HUESER, THOMAS GERALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERALD
Last Name:HUESER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2305 E 52ND ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2762
Mailing Address - Country:US
Mailing Address - Phone:563-355-9424
Mailing Address - Fax:563-355-0180
Practice Address - Street 1:2305 E 52ND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2762
Practice Address - Country:US
Practice Address - Phone:563-355-9424
Practice Address - Fax:563-355-0180
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA080461223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery