Provider Demographics
NPI:1417601808
Name:IHORTH DENTAL LLC
Entity Type:Organization
Organization Name:IHORTH DENTAL LLC
Other - Org Name:IRONHORSE FAMILY AND COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWDOIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:913-624-4800
Mailing Address - Street 1:1270 W AMITY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66053-7815
Mailing Address - Country:US
Mailing Address - Phone:913-837-3096
Mailing Address - Fax:913-215-5910
Practice Address - Street 1:1270 W AMITY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:KS
Practice Address - Zip Code:66053-7815
Practice Address - Country:US
Practice Address - Phone:913-837-3096
Practice Address - Fax:913-215-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-05
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty