Provider Demographics
NPI:1619997392
Name:HOWERTON, WILLIAM BRUCE JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:HOWERTON
Suffix:JR
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:224 EDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4418
Mailing Address - Country:US
Mailing Address - Phone:919-960-9604
Mailing Address - Fax:
Practice Address - Street 1:3200 BLUE RIDGE RD
Practice Address - Street 2:SUITE 218
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8086
Practice Address - Country:US
Practice Address - Phone:919-534-7000
Practice Address - Fax:919-534-7003
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC55541223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCV04330Medicare UPIN