Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 009831 | CT |
N | 204E00000X | Oral & Maxillofacial Surgeon | 046141 | CT |
NPI | 1114195344 |
---|---|
Provider Name | Joseph Robert Howard |
First Address | Danbury, CT 06810-5635 |
Second Address | Danbury, CT 06810-5635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2008 |
Last Update Date | 11/02/2008 |