Provider Demographics
NPI:1922322445
Name:EMERSON T ROWLEY DMD PC
Entity Type:Organization
Organization Name:EMERSON T ROWLEY DMD PC
Other - Org Name:CORNELIUS DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:971-241-2919
Mailing Address - Street 1:926 BASELINE ST
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113-8312
Mailing Address - Country:US
Mailing Address - Phone:503-359-0339
Mailing Address - Fax:
Practice Address - Street 1:926 BASELINE ST
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:OR
Practice Address - Zip Code:97113-8312
Practice Address - Country:US
Practice Address - Phone:503-359-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9403261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental