Individual
DR. BRODIE LEN BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
28 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1640
(850) 863-2122
Mailing address
28 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1640
(850) 863-2122
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
9750
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN 16286
FL
Other
Enumeration date
10/31/2005
Last updated
02/04/2013
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