Provider Demographics
NPI:1609324599
Name:THOMAS W ROWLEY DDS SC
Entity Type:Organization
Organization Name:THOMAS W ROWLEY DDS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-473-2242
Mailing Address - Street 1:128 N TRATT ST
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-1205
Mailing Address - Country:US
Mailing Address - Phone:262-473-2242
Mailing Address - Fax:262-473-2286
Practice Address - Street 1:128 N TRATT ST
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-1205
Practice Address - Country:US
Practice Address - Phone:262-473-2242
Practice Address - Fax:262-473-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7575350001Medicare NSC