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General NPI Number Information
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NPI Number | 1689399610
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Entity Type | Organization
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Legal Business Name | KEVEN BOWDLE, DDS
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 11232 W POINT DR STE B
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City | KNOXVILLE
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State | TN
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Zip | 37934-2872
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Country | US
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Telephone | 865-966-6711
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Fax | 865-675-0542
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Provider Business Mailing Address
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Address Line | 11232 W POINT DR STE B
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City | KNOXVILLE
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State | TN
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Zip | 37934-2872
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Country | US
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Telephone | 865-966-6711
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Fax | 865-675-0542
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Authorized Official
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Title or Position | OFFICE MANAGE
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Name | FAYE MCKELVEY
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Credential |
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Telephone | 865-660-1578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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