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NPI Code Detail

MEDICARE: DR. JOHN DOUGLAS HUNTLEY DMD

MEDICARE: DR. JOHN DOUGLAS HUNTLEY DMD
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
11223G0001XGeneral Practice Dentistry3413ME
21223G0001XGeneral Practice Dentistry2621NH

General Provider Information

NPI Number : 1477587988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN DOUGLAS HUNTLEY DMD
Provider Business Mailing Address
First Line : 28 GRANDVIEW DR
Second Line :
City : BERLIN
State : NH
Zip : 03570-1536
Country : US
Telephone Number : 603-752-9299
Fax Number :
Provider Business Practice Location Address
First Line : 364 PRITHAM AVE
Second Line : CA DEAN MEMORIAL HOSPITAL
City : GREENVILLE
State : ME
Zip : 04441
Country : US
Telephone Number : 207-695-3767
Fax Number : 207-695-3826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 07/08/2007

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