Organization
ENID DENTISTRY & BRACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN JAMES BOWMAN DDS (MANAGER)
(405) 326-8004
Entity
Organization
Contact information
Practice address
5202 W OWEN K GARRIOTT RD STE A, ENID, OK 73703-4611
(580) 242-5862
Mailing address
5202 W OWEN K GARRIOTT RD STE A, ENID, OK 73703-4611
(580) 242-5862
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6076
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205032935
—
OK
Enumeration date
07/06/2017
Last updated
12/04/2023
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