Provider Demographics
NPI:1962604504
Name:HOWARD-STICKEL, BRANDI (DDS)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:
Last Name:HOWARD-STICKEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 DANIEL DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8002
Mailing Address - Country:US
Mailing Address - Phone:172-443-7093
Mailing Address - Fax:
Practice Address - Street 1:110 DANIEL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8002
Practice Address - Country:US
Practice Address - Phone:724-437-0937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1376512582OtherNPI ENUMERATOR FOR SITE
PADS037163OtherSTATE LICENSE NUMBER
PA100772557-0003Medicaid