Provider Demographics
NPI:1154300879
Name:VOWELL, ELAINE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:R
Last Name:VOWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 AYRSLEY TOWN BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3542
Mailing Address - Country:US
Mailing Address - Phone:980-297-7071
Mailing Address - Fax:980-297-7074
Practice Address - Street 1:COMPACFLT HEALTH SERVICES (N01HD) ATTN: PAC
Practice Address - Street 2:250 MAKALAPA DRIVE
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-3131
Practice Address - Country:US
Practice Address - Phone:808-471-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8706122300000X, 1223G0001X
NE6463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice