Provider Demographics
NPI:1902052871
Name:HOWARD, TRAVIS L (DDS)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:L
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 1:1610 WILLIS COURT
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1462
Mailing Address - Country:US
Mailing Address - Phone:913-294-2222
Mailing Address - Fax:913-294-2225
Practice Address - Street 1:1610 WILLIS COURT
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071
Practice Address - Country:US
Practice Address - Phone:913-294-2222
Practice Address - Fax:913-294-2225
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS605721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice