# PRINCE GEORGE COSMETIC & FAMILY DENTISTRY, PC

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

## Provider details

- **NPI number:** 1336382522
- **Authorized official:** DR. SHANNON GILL BOWMAN DDS (PRESIDENT)
- **Authorized official phone:** (804) 862-4416

## Contact information

- **Practice address:** 5727 ALLIN RD, PRINCE GEORGE, VA 23875-2343
- **Practice address phone:** (804) 862-4416
- **Practice address fax:** (804) 862-4428
- **Mailing address:** 5727 ALLIN RD, PRINCE GEORGE, VA 23875-2343
- **Mailing address phone:** (804) 862-4416
- **Mailing address fax:** (804) 862-4428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401410885 | VA | Yes |

## Other

- **Enumeration date:** 04/17/2009
- **Last updated:** 04/17/2009