MEDICARE: DR. CHRISTOPHER LEIF ROWE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DE00010489	WA
2	122300000X	Dentist	DE00010489	WA
3	122300000X	Dentist	DN 10489	WA
4	122300000X	Dentist	9078	NC

General Provider Information

NPI Number	:	1003895939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER LEIF ROWE DDS

Provider Business Mailing Address
First Line	:	9225 DOERR RD BLDG 1220
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-2204
Country	:	US
Telephone Number	:	571-231-6004
Fax Number	:

Provider Business Practice Location Address
First Line	:	9225 DOERR RD BLDG 1220
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-2204
Country	:	US
Telephone Number	:	571-231-6004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	08/08/2022

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