Provider Demographics
NPI:1881007334
Name:BOWEN, KATHARINE (DMD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 MASTERS VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8771
Mailing Address - Country:US
Mailing Address - Phone:859-361-6354
Mailing Address - Fax:
Practice Address - Street 1:3141 BEAUMONT CENTRE CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1960
Practice Address - Country:US
Practice Address - Phone:859-223-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist