Terry Odell Bowman, D.D.S.

Individual provider Active NPI General Practice Dentistry · Denton, NC

NPI 1619904786 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619904786
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3898 (NC)
Practice address
49 Anderson St
Denton, NC 27239
Phone
(336) 859-4581
Fax
(336) 859-4582
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
3898NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
G. Chris Holdaway, DDS, II, PA General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3898 NC Yes

Addresses

Primary practice location

49 Anderson St
Denton, NC 27239

Mailing address

PO Box 973
Denton, NC 27239-0973
Phone (336) 859-4581

Other identifiers

IdentifierTypeStateIssuer
89909-16MedicaidNC

Other providers in Denton, NC

All providers in Denton, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.