| Doctor Name: | DR. PAUL JAY HUIZINGA |
| NPI Number: | 1174516363 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS MD |
| License Number: | 2901018332 |
| Business Practice Address: | 4330 44th St Sw Suite 106 Grandville, MI - 494182349 |
| Business Phone Number: | 6165304710 |
| Business Fax Number: | 6165300480 |
| Mailing Address: | 3919 Piute Dr Sw, GRANDVILLE |
| State: | MI |
| Postal Code: | 494182474 |
| Phone Number: | 6165344477 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2005 |
| NPI Last Update Date: | 08/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 2901018332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |