Provider Demographics
NPI:1346308467
Name:HOWENSTEIN, LARRY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:JOSEPH
Last Name:HOWENSTEIN
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 1:10606 LINCOLN TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-1900
Mailing Address - Country:US
Mailing Address - Phone:618-397-6727
Mailing Address - Fax:618-397-6745
Practice Address - Street 1:10606 LINCOLN TRL
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-1900
Practice Address - Country:US
Practice Address - Phone:618-397-6727
Practice Address - Fax:618-397-6745
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A14874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1346308467OtherBLUE CROSS BLUE SHEILD OF IL
IL1346308467OtherBLUE CROSS BLUE SHIELD OF ALABAMA
IL1346308467OtherBLUE CROSS BLUE SHIELD OF MASSACHUSETTES
IL1346308467OtherBLUE CROSS BLUE SHIELD OF ALABAMA