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General NPI Number Information
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NPI Number | 1710024930
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Entity Type | Individual
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Provider Name | PAUL F. BOWERSOX D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 256 E MAIN ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-5552
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Country | US
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Telephone | 410-857-0107
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Fax |
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Provider Business Mailing Address
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Address Line | 206 PENNSYLVANIA AVE
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City | WESTMINSTER
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State | MD
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Zip | 21157-4343
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Country | US
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Telephone | 410-857-0700
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 09965
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License Number State | MD
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