Provider Demographics
NPI:1023184355
Name:DOWDY, DAVID GRANT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GRANT
Last Name:DOWDY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 TRAILWOOD DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-6937
Mailing Address - Country:US
Mailing Address - Phone:662-335-1011
Mailing Address - Fax:662-335-1046
Practice Address - Street 1:1417 TRAILWOOD DR
Practice Address - Street 2:SUITE G
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-6937
Practice Address - Country:US
Practice Address - Phone:662-335-1011
Practice Address - Fax:662-335-1046
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2610-911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice