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Individual

DR. MARK D HUZYAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
400 CELEBRATION PL, A-260, CELEBRATION, FL 34747-4970
(407) 566-2222
(407) 566-1650
Mailing address
741 FRONT ST, #330, CELEBRATION, FL 34747-4991
(407) 566-2222
(407) 566-1650

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN0010531
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31240
GRP ID UNITED HEALTHCARE
FL
01
63681B
PROVIDER ID BCBS FL
FL
01
76
FEE ID WDW WRKER COMP
FL
01
973990
GRP ID UNITED CONCORDIA
FL
Enumeration date
02/28/2007
Last updated
07/08/2007
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