# MELISSA S BOWLER DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** collinsville family dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932374360
- **Authorized official:** DR. MELISSA SUE BOWLER DDS (PRESIDENET)
- **Authorized official phone:** (918) 371-3774

## Contact information

- **Practice address:** 1310 W MAIN ST, COLLINSVILLE, OK 74021-3012
- **Practice address phone:** (918) 371-3774
- **Practice address fax:** (918) 371-5347
- **Mailing address:** 1310 W MAIN ST, COLLINSVILLE, OK 74021-3012
- **Mailing address phone:** (918) 371-3774
- **Mailing address fax:** (918) 371-5347

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5715 | OK | Yes |

## Other

- **Enumeration date:** 04/27/2008
- **Last updated:** 06/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1629080866 | NPI TYPE 1 | OK |