MEDICARE: DR. CHARLES THOMAS HOWARD 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	12909	MO

General Provider Information

NPI Number	:	1386634582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES THOMAS HOWARD D.D.S.

Provider Business Mailing Address
First Line	:	6 OAK RIDGE DR
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-5610
Country	:	US
Telephone Number	:	636-239-7827
Fax Number	:

Provider Business Practice Location Address
First Line	:	1544 SIERRA VISTA PLZ
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63138-2040
Country	:	US
Telephone Number	:	314-355-5700
Fax Number	:	314-355-5702

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/08/2007

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