Provider Demographics
NPI:1467964544
Name:HOWARD, JAMIE HARGETT (DMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:HARGETT
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:KATHERINE
Other - Last Name:HARGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:SDB 412
Mailing Address - Street 2:1720 2ND AVE S
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294
Mailing Address - Country:US
Mailing Address - Phone:205-934-4551
Mailing Address - Fax:205-934-7901
Practice Address - Street 1:418 SCHOOL OF DENTISTRY BUILDING
Practice Address - Street 2:1919 7TH AVE S
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3954-171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics