Healthcare Provider Details

I. General information

NPI: 1659153377
Provider Name (Legal Business Name): MADISON ANNE HUFFMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/17/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 US HIGHWAY 27 N
SEBRING FL
33870-1861
US

IV. Provider business mailing address

3493 OAK KNOLL PT
LAKE MARY FL
32746-5208
US

V. Phone/Fax

Practice location:
  • Phone: 863-657-0395
  • Fax:
Mailing address:
  • Phone: 407-375-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDN29645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: