Provider Demographics
NPI:1639564628
Name:HOWER DENTAL PLLC
Entity Type:Organization
Organization Name:HOWER DENTAL PLLC
Other - Org Name:SANGO FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-662-1706
Mailing Address - Street 1:1011 HIGHWAY 76 STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2531
Mailing Address - Country:US
Mailing Address - Phone:931-553-0106
Mailing Address - Fax:931-553-0336
Practice Address - Street 1:1011 HIGHWAY 76 STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2531
Practice Address - Country:US
Practice Address - Phone:931-553-0106
Practice Address - Fax:931-553-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000098341223G0001X
TNDS00000075081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1871680744OtherNPI
1851649370OtherNPI