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General NPI Number Information
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NPI Number | 1962605790
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Entity Type | Organization
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Legal Business Name | DR. LES FOWLER, DMD
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 181 E WARD ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5547
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Country | US
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Telephone | 336-629-6464
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Fax | 336-629-9737
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Provider Business Mailing Address
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Address Line | 181 E WARD ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5547
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Country | US
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Telephone | 336-629-6464
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Fax | 336-629-9737
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LES FOWLER
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Credential | D.M.D.
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Telephone | 336-629-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | NC 3547
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License Number State | NC
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