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General NPI Number Information
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NPI Number | 1891809919
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Entity Type | Organization
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Legal Business Name | JON BOWIE, D. M. D., P. C.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 4728 AIRPORT BLVD SUITE A
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City | MOBILE
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State | AL
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Zip | 36608-3170
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Country | US
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Telephone | 251-343-1794
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Fax |
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Provider Business Mailing Address
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Address Line | 4728 AIRPORT BLVD SUITE A
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City | MOBILE
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State | AL
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Zip | 36608-3170
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Country | US
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Telephone | 251-343-1794
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JON NATHAN BOWIE
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Credential | D. M. D.
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Telephone | 251-343-1794
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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 | 4905
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License Number State | AL
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