Provider Demographics
NPI:1760702567
Name:BOWSER, ROBERT WALCK (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALCK
Last Name:BOWSER
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 1:2161 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2848
Mailing Address - Country:US
Mailing Address - Phone:717-757-3474
Mailing Address - Fax:717-840-4999
Practice Address - Street 1:2161 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2848
Practice Address - Country:US
Practice Address - Phone:717-757-3474
Practice Address - Fax:717-840-4999
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist