Provider Demographics
NPI:1881733947
Name:KAUFMAN, HOWARD GARY (DDS)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:GARY
Last Name:KAUFMAN
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 1:1777 BELLFLOWER BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4013
Mailing Address - Country:US
Mailing Address - Phone:562-597-5700
Mailing Address - Fax:562-494-3434
Practice Address - Street 1:1777 BELLFLOWER BLVD STE 108
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4013
Practice Address - Country:US
Practice Address - Phone:562-597-5700
Practice Address - Fax:562-494-3434
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289431223E0200X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223E0200XDental ProvidersDentistEndodontics