Provider Demographics
NPI:1063515229
Name:ACHEN, HOWARD M (DDS)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:M
Last Name:ACHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E IDAHO
Mailing Address - Street 2:SUITE 14
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3241
Mailing Address - Country:US
Mailing Address - Phone:505-523-8663
Mailing Address - Fax:505-526-4593
Practice Address - Street 1:225 E IDAHO
Practice Address - Street 2:SUITE 14
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3241
Practice Address - Country:US
Practice Address - Phone:505-523-8663
Practice Address - Fax:505-526-4593
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD12701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice