Healthcare Provider Details

I. General information

NPI: 1609324599
Provider Name (Legal Business Name): THOMAS W ROWLEY DDS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 N TRATT ST
WHITEWATER WI
53190-1205
US

IV. Provider business mailing address

128 N TRATT ST
WHITEWATER WI
53190-1205
US

V. Phone/Fax

Practice location:
  • Phone: 262-473-2242
  • Fax: 262-473-2286
Mailing address:
  • Phone: 262-473-2242
  • Fax: 262-473-2286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DOREEN T ROWLEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 262-473-2242