Provider Demographics
NPI:1346213063
Name:MCDONNELL, HOWARD THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:THOMAS
Last Name:MCDONNELL
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 1:8811 SHADY VLY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5558
Mailing Address - Country:US
Mailing Address - Phone:210-509-8542
Mailing Address - Fax:
Practice Address - Street 1:2450 PEPPERRELL ST
Practice Address - Street 2:
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-5345
Practice Address - Country:US
Practice Address - Phone:210-292-6990
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI128751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics