Provider Demographics
NPI:1386183408
Name:MARY ELIZABETH STARNES HUFFMAN DDS PA
Entity Type:Organization
Organization Name:MARY ELIZABETH STARNES HUFFMAN DDS PA
Other - Org Name:LENOIR FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ES
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-430-8334
Mailing Address - Street 1:342 HARPER AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5061
Mailing Address - Country:US
Mailing Address - Phone:828-754-7252
Mailing Address - Fax:828-754-7253
Practice Address - Street 1:342 HARPER AVE NW STE A
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5061
Practice Address - Country:US
Practice Address - Phone:828-754-7252
Practice Address - Fax:828-754-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915387Medicaid