Blane Bowen, DDS

Individual provider Active NPI General Practice Dentistry · Harrison, MI

NPI 1588046700 · NPPES record last updated Jun 24, 2015

Key facts

NPI
1588046700
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901021620 (MI)
Practice address
815 N Clare Ave
Harrison, MI 48625-8176
Phone
(810) 964-1410
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901021620 MI Yes

Addresses

Primary practice location

815 N Clare Ave
Harrison, MI 48625-8176

Mailing address

1413 Morninglow Dr
Grand Blanc, MI 48439-1717
Phone (810) 964-1410

Other providers in Harrison, MI

All providers in Harrison, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.