Provider Demographics
NPI:1972831501
Name:CHAD A. BOWLES D.D.S., P.A.
Entity Type:Organization
Organization Name:CHAD A. BOWLES D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-491-6663
Mailing Address - Street 1:6811 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2005
Mailing Address - Country:US
Mailing Address - Phone:913-491-6663
Mailing Address - Fax:913-491-2975
Practice Address - Street 1:6811 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2005
Practice Address - Country:US
Practice Address - Phone:913-491-6663
Practice Address - Fax:913-491-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS603921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty