Individual
TAYLOR FOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2250 NE PROFESSIONAL CT, BEND, OR 97701-6063
(541) 325-1243
Mailing address
2250 NE PROFESSIONAL CT, BEND, OR 97701-6063
(541) 325-1243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9910
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2012
Last updated
12/28/2015
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