Organization
C DOUGLAS FOWLER DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DOUGLAS FOWLER DDS (PRESIDENT)
(951) 686-5301
Entity
Organization
Contact information
Practice address
6850 BROCKTON AVENUE, SUITE 103, RIVERSIDE, CA 92506-3826
(951) 686-5301
(951) 686-4375
Mailing address
6850 BROCKTON AVENUE, SUITE 103, RIVERSIDE, CA 92506-3826
(951) 686-5301
(951) 686-4375
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19067
CA
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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