Provider Demographics
NPI:1689868705
Name:FOWLER, JOSHUA PRESTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:PRESTON
Last Name:FOWLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 MAIN ST UNIT A2
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5999
Mailing Address - Country:US
Mailing Address - Phone:970-686-7858
Mailing Address - Fax:
Practice Address - Street 1:1555 MAIN ST UNIT A2
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5999
Practice Address - Country:US
Practice Address - Phone:970-686-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1172122300000X
CODEN.0001014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist