MEDICARE: JOHN N BOWMAN DDSPC

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	7993	GA

General Provider Information

NPI Number	:	1740496280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN N BOWMAN DDSPC

Provider Business Mailing Address
First Line	:	133 LAMAR ST.
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31204
Country	:	US
Telephone Number	:	478-746-8836
Fax Number	:	478-746-0280

Provider Business Practice Location Address
First Line	:	133 LAMAR ST
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31204-3007
Country	:	US
Telephone Number	:	478-746-8836
Fax Number	:	478-746-0280

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN NORMAN BOWMAN
Credential	:	D.D.S.
Telephone Number	:	478-746-8836

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	02/28/2012

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