Provider Demographics
NPI:1922143676
Name:HOWELL, BRUCE TUCKER (DMD PA)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:TUCKER
Last Name:HOWELL
Suffix:
Gender:M
Credentials:DMD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E BUFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3314
Mailing Address - Country:US
Mailing Address - Phone:864-964-9004
Mailing Address - Fax:864-964-1615
Practice Address - Street 1:102 E BUFORD AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3314
Practice Address - Country:US
Practice Address - Phone:864-964-9004
Practice Address - Fax:864-964-1615
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26551223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics