Provider Demographics
NPI:1184815904
Name:BOWMAN, MICHAEL C (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:BOWMAN
Suffix:
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 1:22 2ND AVE W
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4466
Mailing Address - Country:US
Mailing Address - Phone:406-752-8888
Mailing Address - Fax:
Practice Address - Street 1:22 2ND AVE W
Practice Address - Street 2:SUITE 3000
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4466
Practice Address - Country:US
Practice Address - Phone:406-752-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice