# LYNN R BOWEN DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164729851
- **Authorized official:** DR. LYNN R BOWEN DDS (PRESIDENT)
- **Authorized official phone:** (260) 463-7006

## Contact information

- **Practice address:** 210 W SOUTH ST, LAGRANGE, IN 46761-2233
- **Practice address phone:** (260) 463-7006
- **Practice address fax:** (260) 463-4135
- **Mailing address:** 210 W SOUTH ST, LAGRANGE, IN 46761-2233
- **Mailing address phone:** (260) 463-7006
- **Mailing address fax:** (260) 463-4135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12008550A | IN | Yes |

## Other

- **Enumeration date:** 02/16/2011
- **Last updated:** 02/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200956730A | — | IN |