Individual
DR. BRENDA LYLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2408 S LAMAR BLVD, SUITE 3, OXFORD, MS 38655-5345
(662) 513-4619
(662) 513-5528
Mailing address
2408 S LAMAR BLVD, SUITE 3, OXFORD, MS 38655-5345
(662) 513-4619
(662) 513-5528
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3912-17
MS
Other
Enumeration date
08/05/2007
Last updated
04/27/2017
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