Provider Demographics
NPI:1851687792
Name:HUH, MARK IN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:IN
Last Name:HUH
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 1:700 ROUTE 130 N STE 204
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3366
Mailing Address - Country:US
Mailing Address - Phone:856-829-8668
Mailing Address - Fax:
Practice Address - Street 1:700 ROUTE 130 N STE 204
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3366
Practice Address - Country:US
Practice Address - Phone:856-829-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037953122300000X
NJ22DI02501300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist