Healthcare Provider Details

I. General information

NPI: 1063582419
Provider Name (Legal Business Name): CONSTANCE C. HUFF D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 COLLIN DR
HARRODSBURG KY
40330-1168
US

IV. Provider business mailing address

135 COLLIN DR
HARRODSBURG KY
40330-1168
US

V. Phone/Fax

Practice location:
  • Phone: 859-734-4944
  • Fax: 859-734-0476
Mailing address:
  • Phone: 859-734-4944
  • Fax: 859-734-0476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5900
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5900
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: