Provider Demographics
NPI:1588778492
Name:HUFF, ALAN CRAIG (DDS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:CRAIG
Last Name:HUFF
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 1:6780 LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-4535
Mailing Address - Country:US
Mailing Address - Phone:866-807-7161
Mailing Address - Fax:
Practice Address - Street 1:6780 LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-4535
Practice Address - Country:US
Practice Address - Phone:866-807-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025677L1223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011667820002Medicaid