Provider Demographics
NPI:1265430789
Name:HOWARD, DANIEL B (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
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 1:2274 N EAGLE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6285
Mailing Address - Country:US
Mailing Address - Phone:208-965-9041
Mailing Address - Fax:
Practice Address - Street 1:2274 N EAGLE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-6285
Practice Address - Country:US
Practice Address - Phone:208-965-9041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10119122300000X
IDD-3358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist