Provider Demographics
NPI:1528074754
Name:HUFFSTUTLER, STEVEN M (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:HUFFSTUTLER
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 1:4968 OVERTON RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-1909
Mailing Address - Country:US
Mailing Address - Phone:817-263-0181
Mailing Address - Fax:817-292-8232
Practice Address - Street 1:4968 OVERTON RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-1909
Practice Address - Country:US
Practice Address - Phone:817-263-0181
Practice Address - Fax:817-292-8232
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice