Provider Demographics
NPI:1659637213
Name:HUFFMAN, BRADFORD PERRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:PERRY
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 EVANS TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4315
Mailing Address - Country:US
Mailing Address - Phone:706-724-8735
Mailing Address - Fax:
Practice Address - Street 1:7011 EVANS TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4315
Practice Address - Country:US
Practice Address - Phone:706-724-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA144541223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery