Provider Demographics
NPI:1841429644
Name:ANNIE EDWARDS HOWARD DDS PC
Entity Type:Organization
Organization Name:ANNIE EDWARDS HOWARD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:229-432-7440
Mailing Address - Street 1:2420 WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2249
Mailing Address - Country:US
Mailing Address - Phone:229-432-7440
Mailing Address - Fax:229-432-7388
Practice Address - Street 1:2420 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2249
Practice Address - Country:US
Practice Address - Phone:229-432-7440
Practice Address - Fax:229-432-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0117851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty