Individual
JIM BOWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
14024
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
14024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
825442
UNITED CONCORDIA PROVIDER
TX
Enumeration date
07/03/2008
Last updated
07/03/2008
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