MEDICARE: MELISSA HOWINGTON

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	124Q00000X	Dental Hygienist	2902010239	MI

General Provider Information

NPI Number	:	1457780157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HOWINGTON

Provider Business Mailing Address
First Line	:	8312 CLARKLAKE RD
Second Line	:
City	:	CLARKLAKE
State	:	MI
Zip	:	49234-9765
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8312 CLARKLAKE RD
Second Line	:
City	:	CLARKLAKE
State	:	MI
Zip	:	49234-9765
Country	:	US
Telephone Number	:	269-275-4153
Fax Number	:

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

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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Directions to “ MELISSA HOWINGTON ” Practice Location

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