Provider Demographics
NPI:1295951119
Name:HOWELL, JESSICA (DDS)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-5312
Mailing Address - Country:US
Mailing Address - Phone:765-674-9959
Mailing Address - Fax:765-674-0854
Practice Address - Street 1:840 E 45TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-5312
Practice Address - Country:US
Practice Address - Phone:765-674-9959
Practice Address - Fax:765-674-0854
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010410A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist