Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 60646 | KS |
NPI | 1003042391 |
---|---|
Provider Name | Dr. Matthew Daniel Howell |
First Address | Wichita, KS 67206 |
Second Address | Wichita, KS 67206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2009 |
Last Update Date | 24/02/2012 |