Provider Demographics
NPI:1730643818
Name:313 ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:313 ORTHODONTICS, PLLC
Other - Org Name:HOWELL ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:586-242-6789
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-0586
Mailing Address - Country:US
Mailing Address - Phone:586-242-6789
Mailing Address - Fax:
Practice Address - Street 1:11525 HIGHLAND RD STE 22
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2726
Practice Address - Country:US
Practice Address - Phone:586-242-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty