MEDICARE: REWAN BOWEN 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	1223G0001X	General Practice Dentistry	DN17481	FL

General Provider Information

NPI Number	:	1053421008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REWAN BOWEN DDS

Provider Business Mailing Address
First Line	:	1762 BRACKENHURST PL
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-4609
Country	:	US
Telephone Number	:	407-388-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1585 ROCK SPRINGS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-2231
Country	:	US
Telephone Number	:	407-884-1846
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/25/2023

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Directions to “ REWAN BOWEN DDS” Practice Location

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