Provider Demographics
NPI:1770186959
Name:DANIEL C. MCEOWEN DDS PC
Entity Type:Organization
Organization Name:DANIEL C. MCEOWEN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MCEOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-432-6201
Mailing Address - Street 1:20311 LAPPANS ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713
Mailing Address - Country:US
Mailing Address - Phone:301-432-6201
Mailing Address - Fax:304-432-6200
Practice Address - Street 1:20311 LAPPANS ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713
Practice Address - Country:US
Practice Address - Phone:301-432-6201
Practice Address - Fax:304-432-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty