Provider Demographics
NPI:1467586016
Name:BOWDLE, DONALD KEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:KEVEN
Last Name:BOWDLE
Suffix:
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 1:11232B W POINT DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2837
Mailing Address - Country:US
Mailing Address - Phone:865-966-6711
Mailing Address - Fax:865-675-0542
Practice Address - Street 1:11232B W POINT DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2837
Practice Address - Country:US
Practice Address - Phone:865-966-6711
Practice Address - Fax:865-675-0542
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS51291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice