Provider Demographics
NPI:1619607892
Name:CHRISTOPHER BOWERS DMD PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER BOWERS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WALDEN
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-906-8608
Mailing Address - Street 1:257 GOLD ST PH N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2085
Mailing Address - Country:US
Mailing Address - Phone:843-906-8608
Mailing Address - Fax:
Practice Address - Street 1:567 PACIFIC ST
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4878
Practice Address - Country:US
Practice Address - Phone:843-906-8608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-12
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty