Provider Demographics
NPI:1497991657
Name:HOWARD UNIVERSITY COLLEGE OF DENTISTRY
Entity Type:Organization
Organization Name:HOWARD UNIVERSITY COLLEGE OF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-806-0019
Mailing Address - Street 1:600 W STREET NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON D.C.
Mailing Address - State:DC
Mailing Address - Zip Code:20743
Mailing Address - Country:US
Mailing Address - Phone:202-806-0019
Mailing Address - Fax:
Practice Address - Street 1:600 W STREET NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON D.C.
Practice Address - State:DC
Practice Address - Zip Code:20743
Practice Address - Country:US
Practice Address - Phone:202-806-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN2858261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental