Provider Demographics
NPI:1174949408
Name:NORMAN F. HUEFNER DMD A PROF CORP
Entity type:Organization
Organization Name:NORMAN F. HUEFNER DMD A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:HUEFNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:949-495-6322
Mailing Address - Street 1:30131 TOWN CENTER DR STE 160
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2040
Mailing Address - Country:US
Mailing Address - Phone:949-495-6322
Mailing Address - Fax:949-495-0642
Practice Address - Street 1:30131 TOWN CENTER DR
Practice Address - Street 2:160
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2034
Practice Address - Country:US
Practice Address - Phone:949-495-6322
Practice Address - Fax:949-495-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty