Provider Demographics
NPI:1043819451
Name:HOWZE, SHANNA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:
Last Name:HOWZE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHANNA
Other - Middle Name:
Other - Last Name:RAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:601 IKE RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-7413
Mailing Address - Country:US
Mailing Address - Phone:210-632-2818
Mailing Address - Fax:
Practice Address - Street 1:1750 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3400
Practice Address - Country:US
Practice Address - Phone:817-473-6857
Practice Address - Fax:817-473-3256
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice