Provider Demographics
NPI:1659153377
Name:HUFFMAN, MADISON ANNE (DDS)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:ANNE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3493 OAK KNOLL PT
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5208
Mailing Address - Country:US
Mailing Address - Phone:407-375-2039
Mailing Address - Fax:
Practice Address - Street 1:2190 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1861
Practice Address - Country:US
Practice Address - Phone:863-657-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29645261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental