Provider Demographics
NPI:1225054885
Name:MCCORD, HOWARD EDGAR JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:EDGAR
Last Name:MCCORD
Suffix:JR
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 1:103 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-1939
Mailing Address - Country:US
Mailing Address - Phone:870-265-5098
Mailing Address - Fax:870-265-4099
Practice Address - Street 1:103 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1939
Practice Address - Country:US
Practice Address - Phone:870-265-5098
Practice Address - Fax:870-265-4099
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist