Provider Demographics
NPI:1720281694
Name:HUXFORD, MARY PAIGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:PAIGE
Last Name:HUXFORD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 TUXFORD RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4062
Mailing Address - Country:US
Mailing Address - Phone:662-324-2406
Mailing Address - Fax:
Practice Address - Street 1:100 BRANDON RD
Practice Address - Street 2:SUITE W
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2571
Practice Address - Country:US
Practice Address - Phone:662-323-9726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3355-051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry