MEDICARE: KENNETH AUSTIN HOWIE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	372	CO

General Provider Information

NPI Number	:	1154494920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH AUSTIN HOWIE D.D.S.

Provider Business Mailing Address
First Line	:	1337 RIVERSIDE AVE.
Second Line	:	SUITE 2
City	:	FT. COLLINS
State	:	CO
Zip	:	80524-4373
Country	:	US
Telephone Number	:	970-221-3020
Fax Number	:	970-482-7562

Provider Business Practice Location Address
First Line	:	1337 RIVERSIDE AVE
Second Line	:	SUITE 2
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4373
Country	:	US
Telephone Number	:	970-221-3020
Fax Number	:	970-482-7562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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