Provider Demographics
NPI:1518183474
Name:HOWELL, CHRISTIAN CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:CHARLES
Last Name:HOWELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 DUPONT SQUARE NORTH
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-895-3473
Mailing Address - Fax:502-897-3795
Practice Address - Street 1:1013 DUPONT SQUARE NORTH
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KS
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-895-3473
Practice Address - Fax:502-897-3795
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY78291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60063435Medicaid