Healthcare Provider Details

I. General information

NPI: 1164737953
Provider Name (Legal Business Name): MICHAEL DOUGLAS HUFFER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4508 HOLLY SPRINGS PKWY
CANTON GA
30115-7461
US

IV. Provider business mailing address

421 EPPERSON RD
CANTON GA
30115-6637
US

V. Phone/Fax

Practice location:
  • Phone: 770-213-1726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN015954
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4710
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: