Healthcare Provider Details

I. General information

NPI: 1902573801
Provider Name (Legal Business Name): KRISTEN JADE HOWARD DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 08/27/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 UULA ST.
UTQIAGVIK AK
99723-0029
US

IV. Provider business mailing address

PO BOX 642
BARROW AK
99723-0642
US

V. Phone/Fax

Practice location:
  • Phone: 907-852-9221
  • Fax: 907-852-9297
Mailing address:
  • Phone: 931-273-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number180991
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: