Provider Demographics
NPI:1083704399
Name:NATHAN M DOWNEY DDS, MS, INC
Entity Type:Organization
Organization Name:NATHAN M DOWNEY DDS, MS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:419-352-8453
Mailing Address - Street 1:735 HASKINS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1638
Mailing Address - Country:US
Mailing Address - Phone:419-352-8453
Mailing Address - Fax:419-353-3309
Practice Address - Street 1:735 HASKINS RD
Practice Address - Street 2:SUITE C
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-1638
Practice Address - Country:US
Practice Address - Phone:419-352-8453
Practice Address - Fax:419-353-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH210251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty