Individual
CHARLES RAYMOND BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
58 COURT ST, MIDDLEBURY, VT 05753-4450
(802) 388-6344
(802) 388-4103
Mailing address
58 COURT ST, MIDDLEBURY, VT 05753-4450
(802) 388-6344
(802) 388-4103
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0160000507
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02500030
—
NY
01
—
102V102
MVP
VT
01
—
1565
BLUE CROSS
VT
05
—
1565
—
VT
Enumeration date
07/31/2006
Last updated
09/01/2010
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