Provider Demographics
NPI:1063621845
Name:HARBOUR VIEW DENTAL CENTER, PLC
Entity type:Organization
Organization Name:HARBOUR VIEW DENTAL CENTER, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-686-3636
Mailing Address - Street 1:5837 HARBOUR VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435
Mailing Address - Country:US
Mailing Address - Phone:757-686-3636
Mailing Address - Fax:757-686-3737
Practice Address - Street 1:5837 HARBOUR VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435
Practice Address - Country:US
Practice Address - Phone:757-686-3636
Practice Address - Fax:757-686-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010072661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty