Provider Demographics
NPI:1053802942
Name:HUESTON, DEVIN (DDS)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:HUESTON
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 1:220 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2572
Mailing Address - Country:US
Mailing Address - Phone:231-347-6932
Mailing Address - Fax:
Practice Address - Street 1:308 STATE ST STE 3
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-4700
Practice Address - Country:US
Practice Address - Phone:231-347-6932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010226861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice