Provider Demographics
NPI:1003012527
Name:HOWARD, PHILIP R (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:R
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 42ND AVE SW STE 23
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4240
Mailing Address - Country:US
Mailing Address - Phone:206-938-1777
Mailing Address - Fax:
Practice Address - Street 1:4520 42ND AVE SW STE 23
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4240
Practice Address - Country:US
Practice Address - Phone:206-938-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist