=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205516077
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERIC W. HOWARD DMD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2023
-----------------------------------------------------
Last Update Date | 07/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2847 WILLOW STREET PIKE N
-----------------------------------------------------
City | WILLOW STREET
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17584-9217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-464-0177
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 388 WHEATFIELD DR
-----------------------------------------------------
City | LITITZ
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17543-6406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-471-3635
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ERIC W HOWARD
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 717-464-0177
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------