Provider Demographics
NPI:1598765745
Name:PANGBURN, HOWARD OWEN JR (DDS)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:OWEN
Last Name:PANGBURN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4449
Mailing Address - Country:US
Mailing Address - Phone:972-255-1102
Mailing Address - Fax:972-255-0622
Practice Address - Street 1:3000 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4449
Practice Address - Country:US
Practice Address - Phone:972-255-1102
Practice Address - Fax:972-255-0622
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice