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General NPI Number Information
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NPI Number | 1376604017
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Entity Type | Organization
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Legal Business Name | HOWARD E. WILT, DDS, PC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1455 E GUADALUPE RD SUITE 2
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City | TEMPE
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State | AZ
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Zip | 85283-3951
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Country | US
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Telephone | 480-838-5422
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Fax | 480-838-3794
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Provider Business Mailing Address
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Address Line | 1455 E. GUADALUPE RD SUITE 2
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City | TEMPE
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State | AZ
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Zip | 85283-3951
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Country | US
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Telephone | 480-838-5422
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Fax | 480-838-3794
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HOWARD EMERY WILT
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Credential | D.D.S.
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Telephone | 480-838-5422
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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 | 1590
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License Number State | AZ
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