Provider Demographics
NPI:1164582870
Name:THOMAS J BOWER DMD
Entity Type:Organization
Organization Name:THOMAS J BOWER DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-372-0600
Mailing Address - Street 1:323 SO MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01835
Mailing Address - Country:US
Mailing Address - Phone:978-382-0600
Mailing Address - Fax:978-374-6148
Practice Address - Street 1:323 SO MAIN ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:MA
Practice Address - Zip Code:01835
Practice Address - Country:US
Practice Address - Phone:978-382-0600
Practice Address - Fax:978-374-6148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17474122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty