Provider Demographics
NPI:1417310566
Name:HUNTINGBURG FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HUNTINGBURG FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHEDULING & INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBBEHUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-683-4100
Mailing Address - Street 1:517 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-1004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:517 E 5TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-1004
Practice Address - Country:US
Practice Address - Phone:812-683-4100
Practice Address - Fax:812-683-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental