Provider Demographics
NPI:1740490275
Name:BOWLES, THOMAS ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALBERT
Last Name:BOWLES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5677 BENEVA RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-4103
Mailing Address - Country:US
Mailing Address - Phone:941-923-3545
Mailing Address - Fax:941-922-9247
Practice Address - Street 1:5677 BENEVA RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-4103
Practice Address - Country:US
Practice Address - Phone:941-923-3545
Practice Address - Fax:941-922-9247
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist