Provider Demographics
NPI:1346553658
Name:HUZA, KATHLEEN DUNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:DUNN
Last Name:HUZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TECHNOLOGY DR UNIT C106
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6347
Mailing Address - Country:US
Mailing Address - Phone:203-445-6000
Mailing Address - Fax:475-231-1041
Practice Address - Street 1:115 TECHNOLOGY DR UNIT C106
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6347
Practice Address - Country:US
Practice Address - Phone:203-445-6000
Practice Address - Fax:475-231-1041
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT127251223E0200X
NY0560131223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics