Healthcare Provider Details

I. General information

NPI: 1649395757
Provider Name (Legal Business Name): HUFF & LUNSFORD, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 W DIXIE AVE
LEESBURG FL
34748-6310
US

IV. Provider business mailing address

1018 W DIXIE AVE
LEESBURG FL
34748-6310
US

V. Phone/Fax

Practice location:
  • Phone: 352-787-3310
  • Fax: 352-787-5927
Mailing address:
  • Phone: 352-787-3310
  • Fax: 352-787-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4813
License Number StateFL

VIII. Authorized Official

Name: DR. RICHARD EDWARD HUFF
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 352-787-3310