Individual
MATTHEW A FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
347 W IOWA AVE, NAMPA, ID 83686-2856
(208) 468-9699
(208) 461-9024
Mailing address
347 W IOWA AVE, NAMPA, ID 83686-2856
(208) 468-9699
(208) 461-9024
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D-3264-EN
ID
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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