Provider Demographics
NPI:1053506691
Name:BOWLIN, EUGENE F JR (DDS)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:F
Last Name:BOWLIN
Suffix:JR
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 1:25 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2032
Mailing Address - Country:US
Mailing Address - Phone:541-664-1525
Mailing Address - Fax:541-665-3373
Practice Address - Street 1:25 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2032
Practice Address - Country:US
Practice Address - Phone:541-664-1525
Practice Address - Fax:541-665-3373
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63801223G0001X
HI13721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice