Healthcare Provider Details

I. General information

NPI: 1497981344
Provider Name (Legal Business Name): MARY E.S. HUFFMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 BURKEMONT AVENUE
MORGANTON NC
28655-4501
US

IV. Provider business mailing address

918 BURKEMONT AVENUE
MORGANTON NC
28655-4501
US

V. Phone/Fax

Practice location:
  • Phone: 828-430-8334
  • Fax: 828-430-6997
Mailing address:
  • Phone: 828-430-8334
  • Fax: 828-430-6997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8767
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: