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Individual

DR. KENNETH MCGOWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1123 E MAIN ST, MEDFORD, OR 97504-7434
(541) 773-3422
(541) 779-2250
Mailing address
1123 E MAIN ST, MEDFORD, OR 97504-7434
(541) 773-3422
(541) 779-2250

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9844
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5006546600
OR
Enumeration date
08/19/2011
Last updated
09/26/2016
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