MEDICARE: JEFF C HUFFMAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	016269	OH

General Provider Information

NPI Number	:	1073770970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFF C HUFFMAN D.D.S.

Provider Business Mailing Address
First Line	:	3091 SULLIVANT AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1831
Country	:	US
Telephone Number	:	614-351-8235
Fax Number	:

Provider Business Practice Location Address
First Line	:	3091 SULLIVANT AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1831
Country	:	US
Telephone Number	:	614-351-8235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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