Provider Demographics
NPI:1053300343
Name:SEPLOWITZ, HOWARD (DMD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:
Last Name:SEPLOWITZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MAIN ST
Mailing Address - Street 2:PO BOX 287
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3317
Mailing Address - Country:US
Mailing Address - Phone:781-438-0331
Mailing Address - Fax:
Practice Address - Street 1:106 MAIN ST
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3317
Practice Address - Country:US
Practice Address - Phone:781-438-0331
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131011223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX04060OtherBCBS
T56502Medicare UPIN