Healthcare Provider Details
I. General information
NPI: 1114195344
Provider Name (Legal Business Name): JOSEPH ROBERT HOWARD DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/11/2008
Last Update Date: 10/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
836 FARMINGTON AVE STE 223
WEST HARTFORD CT
06119
US
IV. Provider business mailing address
836 FARMINGTON AVE STE 223
WEST HARTFORD CT
06119
US
V. Phone/Fax
- Phone: 203-790-0183
- Fax: 203-743-7401
- Phone: 203-790-0183
- Fax: 203-743-7401
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | 009831 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204E00000X |
| Taxonomy | Oral & Maxillofacial Surgery (D.M.D.) |
| License Number | 046141 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: