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General NPI Number Information
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NPI Number | 1457073967
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Entity Type | Organization
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Legal Business Name | HOWARD DENTAL, LLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 6328 E BROWN RD STE 105
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City | MESA
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State | AZ
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Zip | 85205-4841
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Country | US
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Telephone | 480-325-7639
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Fax | 480-654-8965
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Provider Business Mailing Address
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Address Line | 6328 E BROWN RD STE 105
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City | MESA
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State | AZ
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Zip | 85205-4841
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Country | US
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Telephone | 480-325-7639
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Fax | 480-654-8965
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Authorized Official
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Title or Position | MANAGER
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Name | STEPHEN G HOWARD
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Credential | DDS
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Telephone | 907-229-1325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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