Provider Demographics
NPI:1386679629
Name:HUXFORD, ANDREW J (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:HUXFORD
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 1:806 BUCHANAN BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2130
Mailing Address - Country:US
Mailing Address - Phone:702-293-0205
Mailing Address - Fax:702-294-0205
Practice Address - Street 1:806 BUCHANAN BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2130
Practice Address - Country:US
Practice Address - Phone:702-293-0205
Practice Address - Fax:702-294-0205
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV44991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice