Provider Demographics
NPI:1043372568
Name:HUEBNER, DENNIS LAVERNE (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LAVERNE
Last Name:HUEBNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CHURCH ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-2836
Mailing Address - Country:US
Mailing Address - Phone:203-729-0200
Mailing Address - Fax:203-729-8292
Practice Address - Street 1:305 CHURCH ST
Practice Address - Street 2:SUITE #1
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-2836
Practice Address - Country:US
Practice Address - Phone:203-729-0200
Practice Address - Fax:203-729-8292
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT21108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine