Provider Demographics
NPI:1477537454
Name:WILLIAM S HOWARD DDS INC
Entity Type:Organization
Organization Name:WILLIAM S HOWARD DDS INC
Other - Org Name:THE TELLICO DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-253-3403
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:TELLICO PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37385-0119
Mailing Address - Country:US
Mailing Address - Phone:423-253-3403
Mailing Address - Fax:423-253-6051
Practice Address - Street 1:415 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TELLICO PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37385-5090
Practice Address - Country:US
Practice Address - Phone:423-253-3403
Practice Address - Fax:423-253-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN034981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2983OtherDORAL DENTAL
TN4213OtherBCBST
TN4357OtherDORAL DENTAL
NC899016NMedicaid