Roger Kenton Bowman, DMD

Individual provider Active NPI General Practice Dentistry · Glasgow, KY

NPI 1295837565 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295837565
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4486 (KY)
Practice address
1010 A Glenview Dr
Glasgow, KY 42141
Phone
(270) 651-8941
Fax
(270) 651-8941
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4486KYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4486 KY Yes

Addresses

Primary practice location

1010 A Glenview Dr
Glasgow, KY 42141

Mailing address

1010 A Glenview Dr
Glasgow, KY 42141
Phone (270) 651-8941

Other identifiers

IdentifierTypeStateIssuer
60044864MedicaidKY

Other providers in Glasgow, KY

All providers in Glasgow, KY · General Practice Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.