Provider Demographics
NPI:1255869657
Name:HUYNH, DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 ABERDEEN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4646
Mailing Address - Country:US
Mailing Address - Phone:617-834-3456
Mailing Address - Fax:
Practice Address - Street 1:17 YOUNG ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1420
Practice Address - Country:US
Practice Address - Phone:508-753-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18575721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice