Healthcare Provider Details

I. General information

NPI: 1235587940
Provider Name (Legal Business Name): STEPHEN HUFFMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 MAPLE ST
BELPRE OH
45714-2449
US

IV. Provider business mailing address

218 MAPLE ST
BELPRE OH
45714-2449
US

V. Phone/Fax

Practice location:
  • Phone: 740-423-5551
  • Fax: 740-423-6988
Mailing address:
  • Phone: 740-423-5551
  • Fax: 740-423-6988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.024451
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: