Provider Demographics
NPI:1356351639
Name:HUGGINS, JOHN OLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:OLEN
Last Name:HUGGINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 KINWEST PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3409
Mailing Address - Country:US
Mailing Address - Phone:972-401-2054
Mailing Address - Fax:972-401-2351
Practice Address - Street 1:1105 KINWEST PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3409
Practice Address - Country:US
Practice Address - Phone:972-401-2054
Practice Address - Fax:972-401-2351
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice