Provider Demographics
NPI:1437339017
Name:CLOWER, THOMAS BARRY (DMD,PC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BARRY
Last Name:CLOWER
Suffix:
Gender:M
Credentials:DMD,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 MULKEY RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1111
Mailing Address - Country:US
Mailing Address - Phone:770-948-1000
Mailing Address - Fax:770-948-4699
Practice Address - Street 1:1595 MULKEY RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1111
Practice Address - Country:US
Practice Address - Phone:770-948-1000
Practice Address - Fax:770-948-4699
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA96261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA9180674Medicaid