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General NPI Number Information
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NPI Number | 1073688529
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Entity Type | Organization
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Legal Business Name | EVERETT & HOWELL DDS
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 202 TUNNELTON ST SUITE 214
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City | KINGWOOD
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State | WV
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Zip | 26537-1452
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Country | US
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Telephone | 304-329-1989
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Fax | 304-329-2550
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Provider Business Mailing Address
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Address Line | 202 TUNNELTON ST SUITE 214
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City | KINGWOOD
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State | WV
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Zip | 26537-1452
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Country | US
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Telephone | 304-329-1989
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Fax | 304-329-2550
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AMY EVERETT
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Credential | DDS
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Telephone | 304-329-1989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3095
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License Number State | WV
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