MEDICARE: DR. ADRIENNE ELWOOD-COWAN D.D.S.

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	7929	NC

General Provider Information

NPI Number	:	1811092497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIENNE ELWOOD-COWAN D.D.S.

Provider Business Mailing Address
First Line	:	3810 N ELM ST STE 201
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-2726
Country	:	US
Telephone Number	:	336-885-9021
Fax Number	:	336-885-9031

Provider Business Practice Location Address
First Line	:	3810 N ELM ST STE 201
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-2726
Country	:	US
Telephone Number	:	336-545-4281
Fax Number	:

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	02/25/2020

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