Provider Demographics
NPI:1881852994
Name:BOWEN, LETICIA C (DDS)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:C
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-5259
Mailing Address - Country:US
Mailing Address - Phone:760-803-0905
Mailing Address - Fax:
Practice Address - Street 1:910 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3438
Practice Address - Country:US
Practice Address - Phone:760-781-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-26
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35601122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist