Provider Demographics
NPI:1871625822
Name:THOMAS R. HUHN DDS, PC
Entity type:Organization
Organization Name:THOMAS R. HUHN DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:HUHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-746-6517
Mailing Address - Street 1:528 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-4547
Mailing Address - Country:US
Mailing Address - Phone:541-746-6517
Mailing Address - Fax:541-741-8060
Practice Address - Street 1:528 MILL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4547
Practice Address - Country:US
Practice Address - Phone:541-746-6517
Practice Address - Fax:541-741-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4734261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR084582Medicaid