Provider Demographics
NPI:1477073526
Name:LAUREN A. HUFFAKER, DDS, PLLC
Entity Type:Organization
Organization Name:LAUREN A. HUFFAKER, DDS, PLLC
Other - Org Name:RED ROCK FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-306-1098
Mailing Address - Street 1:516 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7026
Mailing Address - Country:US
Mailing Address - Phone:405-306-1098
Mailing Address - Fax:
Practice Address - Street 1:1200 S AIR DEPOT BLVD STE I
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4848
Practice Address - Country:US
Practice Address - Phone:405-733-8136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental