Provider Demographics
NPI:1497868277
Name:BOWLES, GREGGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGGORY
Middle Name:
Last Name:BOWLES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:NORMAN
Other - Middle Name:EDWARD
Other - Last Name:BOWLES
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 KEMPSVILLE ROAD. #64398
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23467
Mailing Address - Country:US
Mailing Address - Phone:757-672-8513
Mailing Address - Fax:757-495-7859
Practice Address - Street 1:801 SANDERSON ROAD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322
Practice Address - Country:US
Practice Address - Phone:757-296-3841
Practice Address - Fax:757-495-7859
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007183122300000X
AR3053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U98362OtherUPIN