Provider Demographics
NPI:1447486154
Name:HUFF, MATTHEW P (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:P
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 1:321 W WATER ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028
Mailing Address - Country:US
Mailing Address - Phone:830-896-8343
Mailing Address - Fax:
Practice Address - Street 1:321 W WATER ST
Practice Address - Street 2:SUITE 115
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-896-8343
Practice Address - Fax:406-265-3021
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23541223G0001X
TX277241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice