Provider Demographics
NPI:1407999741
Name:ROWE, ROBERT GROSS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GROSS
Last Name:ROWE
Suffix:JR
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 1:604 NORTH ROAN STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-926-1021
Mailing Address - Fax:423-926-2791
Practice Address - Street 1:604 NORTH ROAN STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-926-1021
Practice Address - Fax:423-926-2791
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist