Provider Demographics
NPI:1659813475
Name:PERSONAL FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:PERSONAL FAMILY DENTISTRY PC
Other - Org Name:DANIEL K. HOWARD DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:308-247-3381
Mailing Address - Street 1:PO BOX 538
Mailing Address - Street 2:
Mailing Address - City:MORRILL
Mailing Address - State:NE
Mailing Address - Zip Code:69358-0538
Mailing Address - Country:US
Mailing Address - Phone:308-247-3381
Mailing Address - Fax:308-225-5240
Practice Address - Street 1:302 COUNTY RD
Practice Address - Street 2:
Practice Address - City:MORRILL
Practice Address - State:NE
Practice Address - Zip Code:69358-4526
Practice Address - Country:US
Practice Address - Phone:308-247-3381
Practice Address - Fax:308-225-5240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSONAL FAMILY DENTISTRY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid