Provider Demographics
NPI:1881774461
Name:HOWARD, MICHAEL LAWRENCE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAWRENCE
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 1:3475 DALLAS HWY SW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-6405
Mailing Address - Country:US
Mailing Address - Phone:770-425-2001
Mailing Address - Fax:
Practice Address - Street 1:3475 DALLAS HWY SW
Practice Address - Street 2:SUITE 310
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6405
Practice Address - Country:US
Practice Address - Phone:770-425-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice