Provider Demographics
NPI:1275219859
Name:BOWIE DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:BOWIE DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HSIANG LAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-483-1750
Mailing Address - Street 1:14300 GALLANT FOX LN STE 208
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4033
Mailing Address - Country:US
Mailing Address - Phone:301-464-3500
Mailing Address - Fax:301-262-3594
Practice Address - Street 1:14300 GALLANT FOX LN STE 208
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4033
Practice Address - Country:US
Practice Address - Phone:301-464-3500
Practice Address - Fax:301-262-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental