Individual
DR. KENNETH SHANE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4906 AMBASSADOR CAFFERY PKWY BLDG O, LAFAYETTE, LA 70508-6962
(337) 981-0144
(337) 981-0162
Mailing address
4906 AMBASSADOR CAFFERY PKWY BLDG O, LAFAYETTE, LA 70508-6962
(337) 981-0144
(337) 981-0162
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5326
LA
Other
Enumeration date
01/30/2007
Last updated
03/23/2023
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