Healthcare Provider Details

I. General information

NPI: 1003895939
Provider Name (Legal Business Name): CHRISTOPHER LEIF ROWE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 DOERR RD BLDG 1220
FORT BELVOIR VA
22060-2204
US

IV. Provider business mailing address

9225 DOERR RD BLDG 1220
FORT BELVOIR VA
22060-2204
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-6004
  • Fax:
Mailing address:
  • Phone: 571-231-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE00010489
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00010489
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN 10489
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9078
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: