Provider Demographics
NPI:1386729630
Name:HOWARD, BRIAN M (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1613 12TH AVE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-7714
Mailing Address - Country:US
Mailing Address - Phone:208-467-3399
Mailing Address - Fax:208-467-3492
Practice Address - Street 1:1613 12TH AVE RD
Practice Address - Street 2:SUITE A
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-7714
Practice Address - Country:US
Practice Address - Phone:208-467-3399
Practice Address - Fax:208-467-3492
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID15061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice