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General NPI Number Information
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NPI Number | 1114333739
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Entity Type | Organization
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Legal Business Name | 89A DENTAL CARE PLLC
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 6455 N VIEWPOINT DR SUITE 600
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-3215
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Country | US
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Telephone | 928-775-8989
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Fax | 928-775-8988
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Provider Business Mailing Address
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Address Line | 6455 N VIEWPOINT DR SUITE 600
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-3215
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Country | US
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Telephone | 928-775-8989
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Fax | 928-775-8988
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Authorized Official
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Title or Position | PRINCIPAL
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Name | DR. CRAIG S. HOWDEN
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Credential | DMD
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Telephone | 928-642-3989
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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 | 20570660-N
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License Number State | AZ
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