MEDICARE: DANIEL B HOWARD DDS

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	122300000X	Dentist	10119	CO
2	122300000X	Dentist	D-3358	ID

General Provider Information

NPI Number	:	1265430789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL B HOWARD DDS

Provider Business Mailing Address
First Line	:	2274 N EAGLE RD
Second Line	:	SUITE 120
City	:	MERIDIAN
State	:	ID
Zip	:	83646-6285
Country	:	US
Telephone Number	:	208-965-9041
Fax Number	:

Provider Business Practice Location Address
First Line	:	2274 N EAGLE RD
Second Line	:	SUITE 120
City	:	MERIDIAN
State	:	ID
Zip	:	83646-6285
Country	:	US
Telephone Number	:	208-965-9041
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	09/10/2012

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