Healthcare Provider Details
I. General information
NPI: 1912316423
Provider Name (Legal Business Name): HUFFMAN & KREGER FAMILY DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2014
Last Update Date: 08/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4346 STARKEY RD SUITE 3
ROANOKE VA
24018-0605
US
IV. Provider business mailing address
4346 STARKEY ROAD SW SUITE 3
ROANOKE VA
24018
US
V. Phone/Fax
- Phone: 540-989-3321
- Fax: 540-989-9753
- Phone: 540-989-3321
- Fax: 540-989-9753
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
D
HUFFMAN
JR.
Title or Position: DENTIST
Credential: DDS
Phone: 540-989-3321