Healthcare Provider Details

I. General information

NPI: 1801348446
Provider Name (Legal Business Name): CARMEN HUFCUT R.D.H. MSDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2279 MOUNT VERNON RD
SOUTHINGTON CT
06489-1007
US

IV. Provider business mailing address

2279 MOUNT VERNON RD
SOUTHINGTON CT
06489-1007
US

V. Phone/Fax

Practice location:
  • Phone: 860-426-0467
  • Fax: 860-426-2509
Mailing address:
  • Phone: 860-426-0467
  • Fax: 860-426-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number004806
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: