Provider Demographics
NPI:1790143600
Name:THOMAS ROWE DENTISTRY PLLC
Entity Type:Organization
Organization Name:THOMAS ROWE DENTISTRY PLLC
Other - Org Name:BRECKENRIDGE FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-915-0439
Mailing Address - Street 1:PO BOX 8737
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-9000
Mailing Address - Country:US
Mailing Address - Phone:970-453-4585
Mailing Address - Fax:970-547-9145
Practice Address - Street 1:400 N PARK AVE
Practice Address - Street 2:#12A
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-8709
Practice Address - Country:US
Practice Address - Phone:970-453-4585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO202040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty