Provider Demographics
NPI:1386633550
Name:DOWD, KIERAN F (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIERAN
Middle Name:F
Last Name:DOWD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3313
Mailing Address - Country:US
Mailing Address - Phone:978-369-2525
Mailing Address - Fax:978-369-2525
Practice Address - Street 1:801 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3313
Practice Address - Country:US
Practice Address - Phone:978-369-2525
Practice Address - Fax:978-369-2525
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204861223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU90471Medicare UPIN
MAX20084Medicare ID - Type Unspecified