Individual
DR. JORDAN SHEA BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1575 N 52ND ST, PHILADELPHIA, PA 19131
(717) 433-6714
Mailing address
350 N CLARK ST FL 6, C/O JULIETTE BOYCE, CHICAGO, IL 60654-4712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039586
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2013
Last updated
09/26/2014
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