Individual
MR. THOMAS V MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1150 12TH ST, CHALLIS, ID 83226-1040
(208) 879-2366
(208) 879-4895
Mailing address
PO BOX 1040, 1150 12TH ST, CHALLIS, ID 83226-1040
(208) 879-2366
(208) 879-4895
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1754
ID
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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