Provider Demographics
NPI:1417085994
Name:HUFFMAN, ERIC F (DMD, MSD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:F
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-1025
Mailing Address - Country:US
Mailing Address - Phone:859-887-1110
Mailing Address - Fax:
Practice Address - Street 1:611 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-1025
Practice Address - Country:US
Practice Address - Phone:859-887-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics