Provider Demographics
NPI:1952451627
Name:BRADFORD S. ROWE DDS PC
Entity Type:Organization
Organization Name:BRADFORD S. ROWE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-627-7131
Mailing Address - Street 1:10277 N STRAITS HWY
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-8839
Mailing Address - Country:US
Mailing Address - Phone:231-627-7131
Mailing Address - Fax:231-627-8972
Practice Address - Street 1:10277 N STRAITS HWY
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-8839
Practice Address - Country:US
Practice Address - Phone:231-627-7131
Practice Address - Fax:231-627-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010138121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty