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Organization
SIDNEY J. FOWLER, D.D.S.
Active
Organization
SIDNEY J. FOWLER, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM A FOWLER RDH (OWNER/ OFFICE MANAGER)
(936) 564-9401
Entity
Organization
Contact information
Practice address
1023 N MOUND ST, SUITE D, NACOGDOCHES, TX 75961-4491
(936) 564-9401
Mailing address
1023 N MOUND ST, SUITE D, NACOGDOCHES, TX 75961-4491
(936) 564-9401
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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