Provider Demographics
NPI:1548208010
Name:THE HUNTINGTON GROUP, P.C.
Entity Type:Organization
Organization Name:THE HUNTINGTON GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:GAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, FACD
Authorized Official - Phone:248-547-8833
Mailing Address - Street 1:26111 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1330
Mailing Address - Country:US
Mailing Address - Phone:248-547-8833
Mailing Address - Fax:248-547-8836
Practice Address - Street 1:26111 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1330
Practice Address - Country:US
Practice Address - Phone:248-547-8833
Practice Address - Fax:248-547-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010095371223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F37742Medicare PIN