Healthcare Provider Details

I. General information

NPI: 1710978432
Provider Name (Legal Business Name): CURTIS J BOWMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S JEFFERSON ST
ENID OK
73701-5529
US

IV. Provider business mailing address

PO BOX 108818
OKLAHOMA CITY OK
73101-8818
US

V. Phone/Fax

Practice location:
  • Phone: 580-242-2800
  • Fax: 580-242-2801
Mailing address:
  • Phone: 405-848-7974
  • Fax: 405-848-0033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number147
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: