Individual
ELIZABETH HALEY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10590 ENDURING FREEDOM DRIVE, US ARMY DENTAL ACTIVITY, FORT DRUM, NY 13602-5005
(315) 772-6234
(315) 774-3558
Mailing address
10590 ENDURING FREEDOM DRIVE, US ARMY DENTAL ACTIVITY, FORT DRUM, NY 13602-5005
(315) 772-6234
(315) 774-3558
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH012335
GA
Other
Enumeration date
09/26/2017
Last updated
06/05/2018
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