Provider Demographics
NPI:1609142363
Name:STOWELL, DEBRA WOLFER (RDH)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:WOLFER
Last Name:STOWELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KARENS WAY
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-1414
Mailing Address - Country:US
Mailing Address - Phone:508-821-6222
Mailing Address - Fax:
Practice Address - Street 1:3 KARENS WAY
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MA
Practice Address - Zip Code:02779-1414
Practice Address - Country:US
Practice Address - Phone:508-821-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH9292124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist