Provider Demographics
NPI:1790860161
Name:ROWAN FAMILY DENTISTRY, INC.
Entity Type:Organization
Organization Name:ROWAN FAMILY DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ROWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-534-4397
Mailing Address - Street 1:730 COULTER DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-2808
Mailing Address - Country:US
Mailing Address - Phone:662-534-4397
Mailing Address - Fax:662-534-6599
Practice Address - Street 1:730 COULTER DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-2807
Practice Address - Country:US
Practice Address - Phone:662-534-4397
Practice Address - Fax:662-534-6599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROWAN FAMILY DENTISTRY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-26
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental