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General NPI Number Information
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NPI Number | 1366988685
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Entity Type | Individual
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Provider Name | REGINA HOWARD RDH
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 6903 WATERMAN AVE
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City | UNIVERSITY CITY
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State | MO
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Zip | 63130-4333
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Country | US
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Telephone | 314-276-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 6502 EL CAMPO CT
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City | FLORISSANT
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State | MO
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Zip | 63033-8118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2014017621
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License Number State | MO
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