Provider Demographics
NPI:1194163956
Name:TUFA, HENI (DMD)
Entity type:Individual
Prefix:DR
First Name:HENI
Middle Name:
Last Name:TUFA
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 1:418 MASSACHUSETTS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3723
Mailing Address - Country:US
Mailing Address - Phone:978-263-7703
Mailing Address - Fax:
Practice Address - Street 1:418 MASSACHUSETTS AVE STE 3
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3723
Practice Address - Country:US
Practice Address - Phone:978-263-7703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856279122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist