Provider Demographics
NPI:1427114289
Name:HOWARD, BRUCE EVAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:EVAN
Last Name:HOWARD
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 1:267 E MAIN ST
Mailing Address - Street 2:SUITE B2
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2874
Mailing Address - Country:US
Mailing Address - Phone:631-724-0343
Mailing Address - Fax:631-724-3179
Practice Address - Street 1:267 E MAIN ST
Practice Address - Street 2:SUITE B2
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2874
Practice Address - Country:US
Practice Address - Phone:631-724-0343
Practice Address - Fax:631-724-3179
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice