MEDICARE: JEFFREY LAWRENCE HOWENSTEIN D.M.D., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223P0221X	Pediatric Dentistry	DDS-09073	IA

General Provider Information

NPI Number	:	1063770808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY LAWRENCE HOWENSTEIN D.M.D., M.S.

Provider Business Mailing Address
First Line	:	708 RED CEDAR CT
Second Line	:
City	:	JEFFERSON
State	:	SD
Zip	:	57038-6898
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 N SIOUX POINT RD
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-5099
Country	:	US
Telephone Number	:	605-242-4700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2012
Last Update Date	:	05/27/2014

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