Provider Demographics
NPI:1063975514
Name:MARIA E VAN HUFFEL DDS, INC.
Entity type:Organization
Organization Name:MARIA E VAN HUFFEL DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN HUFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-476-8999
Mailing Address - Street 1:960 N HAMILTON RD # 108
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3456
Mailing Address - Country:US
Mailing Address - Phone:614-476-8999
Mailing Address - Fax:
Practice Address - Street 1:960 N HAMILTON RD STE 107
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3457
Practice Address - Country:US
Practice Address - Phone:614-476-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty