Provider Demographics
NPI:1063821692
Name:BLISSFUL DENTAL
Entity Type:Organization
Organization Name:BLISSFUL DENTAL
Other - Org Name:DR. BRENDA E. HOWARD DMD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-552-2662
Mailing Address - Street 1:9821 GREENBELT RD
Mailing Address - Street 2:SUITE #205
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2265
Mailing Address - Country:US
Mailing Address - Phone:301-552-2662
Mailing Address - Fax:301-552-6643
Practice Address - Street 1:9821 GREENBELT RD STE 205
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2269
Practice Address - Country:US
Practice Address - Phone:301-552-2662
Practice Address - Fax:301-552-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD77781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty