Healthcare Provider Details

I. General information

NPI: 1447486154
Provider Name (Legal Business Name): MATTHEW P HUFF DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W WATER ST SUITE 115
KERRVILLE TX
78028
US

IV. Provider business mailing address

321 W WATER ST SUITE 115
KERRVILLE TX
78028
US

V. Phone/Fax

Practice location:
  • Phone: 830-896-8343
  • Fax: 406-265-3021
Mailing address:
  • Phone: 830-896-8343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2354
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27724
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: