MEDICARE: DR. MICHAEL H ROWE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4748	NV

General Provider Information

NPI Number	:	1417014762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H ROWE DDS

Provider Business Mailing Address
First Line	:	818 S FIVE SISTERS DR
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84790-4020
Country	:	US
Telephone Number	:	435-628-8788
Fax Number	:

Provider Business Practice Location Address
First Line	:	3896 N MARTIN L KING BLVD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-6603
Country	:	US
Telephone Number	:	702-614-1792
Fax Number	:	702-933-0190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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