Individual
JEROLD TODD FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2870B S MAIN ST, HARRISONBURG, VA 22801-2664
(540) 434-2423
(540) 801-0493
Mailing address
2870B S MAIN ST, HARRISONBURG, VA 22801-2664
(540) 434-2423
(540) 801-0493
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007959
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394207
ANTHEM
VA
01
—
7959
DELTA
VA
01
—
823297
UNITED CONCORDIA
PA
Enumeration date
01/25/2007
Last updated
07/08/2007
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