Provider Demographics
NPI:1568516722
Name:ROWLEY, JACK FRANCIS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:FRANCIS
Last Name:ROWLEY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:F
Other - Last Name:ROWLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:200 W JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4902
Mailing Address - Country:US
Mailing Address - Phone:504-277-5000
Mailing Address - Fax:504-277-6002
Practice Address - Street 1:200 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4902
Practice Address - Country:US
Practice Address - Phone:504-277-5000
Practice Address - Fax:504-277-6002
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice