Healthcare Provider Details

I. General information

NPI: 1124095252
Provider Name (Legal Business Name): TONI A BOWDEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 1005 BOX 110185
FPO AA
34009
US

IV. Provider business mailing address

PSC 1005 BOX 110185
FPO AA
34009
US

V. Phone/Fax

Practice location:
  • Phone: 757-458-2998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8536
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: