Provider Demographics
NPI:1811260136
Name:HOWELL, MARY HOLLIS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:HOLLIS
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 1:3000 MEDICAL ARTS ST
Mailing Address - Street 2:NUMBER A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3305
Mailing Address - Country:US
Mailing Address - Phone:512-479-6633
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL ARTS ST
Practice Address - Street 2:NUMBER A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3305
Practice Address - Country:US
Practice Address - Phone:512-479-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist