MEDICARE: MICHAEL C BOWMAN DDS PLLC

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	261QD0000X	Dental Clinic/Center	2258	MT

General Provider Information

NPI Number	:	1114163326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL C BOWMAN DDS PLLC

Provider Business Mailing Address
First Line	:	22 2ND AVE W
Second Line	:	SUITE 3000
City	:	KALISPELL
State	:	MT
Zip	:	59901-4466
Country	:	US
Telephone Number	:	406-752-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 2ND AVE W
Second Line	:	SUITE 3000
City	:	KALISPELL
State	:	MT
Zip	:	59901-4466
Country	:	US
Telephone Number	:	406-752-8888
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	MICHAEL C BOWMAN
Credential	:	DDS
Telephone Number	:	406-752-8888

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	12/18/2008

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