Provider Demographics
NPI:1932548807
Name:HOWARD, WESLEY (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FORT COUCH RD STE 415
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1050
Mailing Address - Country:US
Mailing Address - Phone:304-575-9505
Mailing Address - Fax:
Practice Address - Street 1:180 FORT COUCH RD STE 415
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1050
Practice Address - Country:US
Practice Address - Phone:412-835-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039568122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist