Provider Demographics
NPI:1114940962
Name:HUIGENS, DANIEL DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DEAN
Last Name:HUIGENS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2187 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-2943
Mailing Address - Country:US
Mailing Address - Phone:909-593-3551
Mailing Address - Fax:909-596-2854
Practice Address - Street 1:2187 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-2943
Practice Address - Country:US
Practice Address - Phone:909-593-3551
Practice Address - Fax:909-596-2854
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA349741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice