Provider Demographics
NPI:1205818093
Name:BOWERS, BRIT EDWIN (DDS)
Entity Type:Individual
Prefix:
First Name:BRIT
Middle Name:EDWIN
Last Name:BOWERS
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 1:801 SUNSET DR
Mailing Address - Street 2:BUILDING A, SUITE 3
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-3033
Mailing Address - Country:US
Mailing Address - Phone:423-610-0556
Mailing Address - Fax:423-952-0780
Practice Address - Street 1:801 SUNSET DR
Practice Address - Street 2:BUILDING A, SUITE 3
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-3033
Practice Address - Country:US
Practice Address - Phone:423-610-0556
Practice Address - Fax:423-952-0780
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS68481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry