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General NPI Number Information
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NPI Number | 1164049235
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Entity Type | Organization
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Legal Business Name | DR JOHN C OWENS LLC
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 184 STATE ROUTE 2026
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City | COAL TOWNSHIP
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State | PA
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Zip | 17866-7813
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Country | US
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Telephone | 570-648-7414
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Fax | 570-648-7410
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Provider Business Mailing Address
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Address Line | PO BOX 246
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City | SHAMOKIN
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State | PA
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Zip | 17872-0246
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Country | US
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Telephone | 570-648-7414
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Fax | 570-648-7410
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | JOHN C OWENS
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Credential | DDS
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Telephone | 570-648-7414
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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 |
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License Number State |
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