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NPI Code Detail

MEDICARE: GRACE CAROLINE BOWERS DMD

MEDICARE: GRACE CAROLINE BOWERS DMD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1912848227
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE CAROLINE BOWERS DMD
Provider Business Mailing Address
First Line : 875 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3513
Country : US
Telephone Number : 901-448-6240
Fax Number :
Provider Business Practice Location Address
First Line : 874 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3514
Country : US
Telephone Number : 901-448-6240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2026
Last Update Date : 04/02/2026

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Directions to “ GRACE CAROLINE BOWERS DMD” Practice Location

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