MEDICARE: DR. SAMANTHA HOWARD, DMD, PC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1932345543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SAMANTHA HOWARD, DMD, PC

Provider Business Mailing Address
First Line	:	25734 HIGHWAY 195
Second Line	:	SUITE 100
City	:	DOUBLE SPRINGS
State	:	AL
Zip	:	35553-2308
Country	:	US
Telephone Number	:	205-489-3482
Fax Number	:	205-489-5552

Provider Business Practice Location Address
First Line	:	25734 HIGHWAY 195
Second Line	:	SUITE 100
City	:	DOUBLE SPRINGS
State	:	AL
Zip	:	35553-2308
Country	:	US
Telephone Number	:	205-489-3482
Fax Number	:	205-489-5552

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMANTHA D HOWARD
Credential	:	D.M.D.
Telephone Number	:	205-489-3482

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	10/28/2011

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