Provider Demographics
NPI:1952506404
Name:BOWLES, THOMAS NATHAN (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:NATHAN
Last Name:BOWLES
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-8043
Mailing Address - Country:US
Mailing Address - Phone:270-554-2026
Mailing Address - Fax:270-554-9164
Practice Address - Street 1:2850 LONE OAK RD.
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-554-2026
Practice Address - Fax:270-554-9164
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY84991223S0112X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist