Provider Demographics
NPI:1588665723
Name:HOWERTON, DAVID WESLEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WESLEY
Last Name:HOWERTON
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 1:2266 MISSION ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1267
Mailing Address - Country:US
Mailing Address - Phone:503-375-2000
Mailing Address - Fax:503-375-3125
Practice Address - Street 1:2266 MISSION ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1267
Practice Address - Country:US
Practice Address - Phone:503-375-2000
Practice Address - Fax:503-375-3125
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD60761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR199869Medicaid
OR199869Medicaid
T92859Medicare UPIN