Provider Demographics
NPI:1659501922
Name:HUERTA, APRIL GEORGIA (RDH)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:GEORGIA
Last Name:HUERTA
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 1:5244 S STATE HIGHWAY 360
Mailing Address - Street 2:SUITE 398
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0956
Mailing Address - Country:US
Mailing Address - Phone:972-314-3104
Mailing Address - Fax:
Practice Address - Street 1:5244 S STATE HIGHWAY 360
Practice Address - Street 2:SUITE 398
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0956
Practice Address - Country:US
Practice Address - Phone:972-314-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13488124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist