Provider Demographics
NPI:1295022390
Name:DOWLEN FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DOWLEN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-881-9398
Mailing Address - Street 1:230 N PLAZA DR
Mailing Address - Street 2:STE 230
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 N PLAZA DR
Practice Address - Street 2:STE 230
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2511
Practice Address - Country:US
Practice Address - Phone:859-881-9398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty