Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 721 | NV |
NPI | 1033289327 |
---|---|
Provider Name | Dr. Christopher John Hussar |
First Address | Reno, NV 89521-5977 |
Second Address | Reno, NV 89521-5977 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |