Provider Demographics
NPI:1851688626
Name:HOUSKE, CHESLEY RAYMOND JR (DDS)
Entity type:Individual
Prefix:DR
First Name:CHESLEY
Middle Name:RAYMOND
Last Name:HOUSKE
Suffix:JR
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 1:1607 CRAVENS AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3203
Mailing Address - Country:US
Mailing Address - Phone:310-782-2008
Mailing Address - Fax:310-782-6431
Practice Address - Street 1:1607 CRAVENS AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3203
Practice Address - Country:US
Practice Address - Phone:310-782-2008
Practice Address - Fax:310-782-6431
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice