Provider Demographics
NPI:1669720967
Name:CUNNINGHAM, HOWARD R (DDS)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:R
Last Name:CUNNINGHAM
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 1:3047 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1403
Mailing Address - Country:US
Mailing Address - Phone:954-566-9812
Mailing Address - Fax:954-630-8277
Practice Address - Street 1:3047 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1403
Practice Address - Country:US
Practice Address - Phone:954-566-9812
Practice Address - Fax:954-630-8277
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN128771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice