Healthcare Provider Details

I. General information

NPI: 1619997392
Provider Name (Legal Business Name): WILLIAM BRUCE HOWERTON JR. DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BLUE RIDGE RD SUITE 218
RALEIGH NC
27612-8086
US

IV. Provider business mailing address

224 EDGEWATER CIR
CHAPEL HILL NC
27516-4418
US

V. Phone/Fax

Practice location:
  • Phone: 919-534-7000
  • Fax: 919-534-7003
Mailing address:
  • Phone: 919-960-9604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number5554
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: