Provider Demographics
NPI:1083759369
Name:FOWLE, STEVEN DOUGLAS (DDS, INC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:FOWLE
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Gender:M
Credentials:DDS, INC
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Mailing Address - Street 1:27800 MEDICAL CENTER RD.
Mailing Address - Street 2:SUITE 155
Mailing Address - City:MISSION VIEJO,
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6442
Mailing Address - Country:US
Mailing Address - Phone:949-364-0590
Mailing Address - Fax:949-364-0739
Practice Address - Street 1:27800 MEDICAL CENTER RD.
Practice Address - Street 2:SUITE 155
Practice Address - City:MISSION VIEJO,
Practice Address - State:CA
Practice Address - Zip Code:92691-6442
Practice Address - Country:US
Practice Address - Phone:949-364-0590
Practice Address - Fax:949-364-0739
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA247771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics