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: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144A LAURENS ST NW
AIKEN SC
29801-3846
US

IV. Provider business mailing address

144A LAURENS ST NW
AIKEN SC
29801-3846
US

V. Phone/Fax

Practice location:
  • Phone: 803-507-4179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4710
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: