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General NPI Number Information
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NPI Number | 1043475858
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Entity Type | Individual
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Provider Name | SHEREA BOWDEN RACHAL DMD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 3439 MCGEHEE RD STE 22B
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City | MONTGOMERY
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State | AL
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Zip | 36111-3392
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Country | US
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Telephone | 334-288-1868
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Fax | 334-288-1825
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Provider Business Mailing Address
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Address Line | PO BOX 12848
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City | ALEXANDRIA
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State | LA
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Zip | 71315
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Country | US
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Telephone | 318-542-4004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5913
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D-0006849-C
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License Number State | AL
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