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Organization
LYNN R BOWEN DDS PC
Active
Organization
LYNN R BOWEN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN R BOWEN DDS (PRESIDENT)
(260) 463-7006
Entity
Organization
Contact information
Practice address
210 W SOUTH ST, LAGRANGE, IN 46761-2233
(260) 463-7006
(260) 463-4135
Mailing address
210 W SOUTH ST, LAGRANGE, IN 46761-2233
(260) 463-7006
(260) 463-4135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008550A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200956730A
—
IN
Enumeration date
02/16/2011
Last updated
02/16/2011
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