# SIDNEY J. FOWLER, D.D.S.

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

## Provider details

- **NPI number:** 1659539708
- **Authorized official:** MRS. KIM A FOWLER RDH (OWNER/ OFFICE MANAGER)
- **Authorized official phone:** (936) 564-9401

## Contact information

- **Practice address:** 1023 N MOUND ST, SUITE D, NACOGDOCHES, TX 75961-4491
- **Practice address phone:** (936) 564-9401
- **Mailing address:** 1023 N MOUND ST, SUITE D, NACOGDOCHES, TX 75961-4491
- **Mailing address phone:** (936) 564-9401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2008
- **Last updated:** 05/27/2008