Provider Demographics
NPI:1750788154
Name:KEVIN D HUFF, DDS, LLC
Entity type:Organization
Organization Name:KEVIN D HUFF, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-364-2011
Mailing Address - Street 1:217 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2905
Mailing Address - Country:US
Mailing Address - Phone:330-364-2011
Mailing Address - Fax:330-602-3001
Practice Address - Street 1:217 W 4TH ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2905
Practice Address - Country:US
Practice Address - Phone:330-364-2011
Practice Address - Fax:330-602-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20488332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment