Provider Demographics
NPI:1558556811
Name:FOWLER ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:FOWLER ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:615-591-4770
Mailing Address - Street 1:511 NEW HIGHWAY 96 W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2470
Mailing Address - Country:US
Mailing Address - Phone:615-591-4770
Mailing Address - Fax:
Practice Address - Street 1:511 NEW HIGHWAY 96 W
Practice Address - Street 2:SUITE 203
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2470
Practice Address - Country:US
Practice Address - Phone:615-591-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty