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General NPI Number Information
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NPI Number | 1114163326
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Entity Type | Organization
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Legal Business Name | MICHAEL C BOWMAN DDS PLLC
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 22 2ND AVE W SUITE 3000
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City | KALISPELL
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State | MT
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Zip | 59901-4466
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Country | US
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Telephone | 406-752-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 22 2ND AVE W SUITE 3000
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City | KALISPELL
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State | MT
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Zip | 59901-4466
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Country | US
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Telephone | 406-752-8888
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MICHAEL C BOWMAN
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Credential | DDS
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Telephone | 406-752-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2258
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License Number State | MT
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