Healthcare Provider Details

I. General information

NPI: 1205031580
Provider Name (Legal Business Name): ROBERT W. MOWER D.D.S., APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26357 MCBEAN PKWY SUITE 255
VALENCIA CA
91355-4488
US

IV. Provider business mailing address

26357 MCBEAN PKWY SUITE 255
VALENCIA CA
91355-4488
US

V. Phone/Fax

Practice location:
  • Phone: 661-255-1515
  • Fax: 661-255-1661
Mailing address:
  • Phone: 661-255-1515
  • Fax: 661-255-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number45296
License Number StateCA

VIII. Authorized Official

Name: ROBERT MOWER
Title or Position: OWNER
Credential: D.D.S.
Phone: 661-255-1515