Healthcare Provider Details

I. General information

NPI: 1467964544
Provider Name (Legal Business Name): JAMIE HARGETT HOWARD DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE KATHERINE HARGETT

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 SCHOOL OF DENTISTRY BUILDING 1919 7TH AVE S
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

SDB 412 1720 2ND AVE S
BIRMINGHAM AL
35294
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4551
  • Fax:
Mailing address:
  • Phone: 205-934-4551
  • Fax: 205-934-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3954-17
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: