MEDICARE: DR. ROBERT BRADLEY ROWEN DMD

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	DN11871	FL

General Provider Information

NPI Number	:	1063466159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BRADLEY ROWEN DMD

Provider Business Mailing Address
First Line	:	9325 GLADES RD
Second Line	:	#106
City	:	BOCA RATON
State	:	FL
Zip	:	33434-3907
Country	:	US
Telephone Number	:	561-488-8999
Fax Number	:

Provider Business Practice Location Address
First Line	:	9325 GLADES RD
Second Line	:	#106
City	:	BOCA RATON
State	:	FL
Zip	:	33434-3907
Country	:	US
Telephone Number	:	561-488-8999
Fax Number	:

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	07/08/2007

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