Provider Demographics
NPI:1497974752
Name:BOWSER CENTER FOR ADVANCED DENTISTRY, LLC
Entity Type:Organization
Organization Name:BOWSER CENTER FOR ADVANCED DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOWSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-757-3474
Mailing Address - Street 1:2161 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2848
Mailing Address - Country:US
Mailing Address - Phone:717-757-3474
Mailing Address - Fax:
Practice Address - Street 1:2161 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2848
Practice Address - Country:US
Practice Address - Phone:717-757-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022344L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316048879OtherNPI TYPE I