Provider Demographics
NPI:1568502730
Name:MICHAEL A MOWER, DDS, PC
Entity Type:Organization
Organization Name:MICHAEL A MOWER, DDS, PC
Other - Org Name:HEATHERWOOD DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-938-2911
Mailing Address - Street 1:13619 N 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1203
Mailing Address - Country:US
Mailing Address - Phone:602-938-2911
Mailing Address - Fax:602-938-5735
Practice Address - Street 1:13619 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1203
Practice Address - Country:US
Practice Address - Phone:602-938-2911
Practice Address - Fax:602-938-5735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty