Provider Demographics
NPI:1639297351
Name:VINCENT, HOWARD MARCUS (DMD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MARCUS
Last Name:VINCENT
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 1:19 DUNBAR RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1312
Mailing Address - Country:US
Mailing Address - Phone:401-749-8050
Mailing Address - Fax:
Practice Address - Street 1:719 ARMISTICE BLVD
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-2746
Practice Address - Country:US
Practice Address - Phone:401-728-1706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN029661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice