Provider Demographics
NPI:1932232949
Name:HUFFMAN, HAYES O (DDS)
Entity Type:Individual
Prefix:
First Name:HAYES
Middle Name:O
Last Name:HUFFMAN
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 1:126 MYRTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-4340
Mailing Address - Country:US
Mailing Address - Phone:318-466-5100
Mailing Address - Fax:
Practice Address - Street 1:12749 HIGHWAY 28 E STE A
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-0735
Practice Address - Country:US
Practice Address - Phone:318-623-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice