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General NPI Number Information
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NPI Number | 1972522944
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Entity Type | Organization
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Legal Business Name | M COWAN & ASSOCIATES DDS PA
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD SUITE 420
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 954-432-7025
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Fax | 954-432-7613
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Provider Business Mailing Address
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Address Line | 9050 PINES BLVD SUITE 420
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6455
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Country | US
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Telephone | 954-432-7025
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Fax | 954-432-7613
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARC COWAN
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Credential | DDS
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Telephone | 954-432-7025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 9476
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 11402
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17373
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 9783
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 16125
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 7432
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License Number State | FL
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