Provider Demographics
NPI:1639167521
Name:HUNTINGTON, NINA ANNA (RDH)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:ANNA
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 W MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-3720
Mailing Address - Country:US
Mailing Address - Phone:507-455-1204
Mailing Address - Fax:507-455-1204
Practice Address - Street 1:245 W MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-3720
Practice Address - Country:US
Practice Address - Phone:507-455-1204
Practice Address - Fax:507-455-1204
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH6328124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist