Provider Demographics
NPI:1104547363
Name:BOWMAN FAMILY DENTISTRY PLLC
Entity type:Organization
Organization Name:BOWMAN FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:540-943-8545
Mailing Address - Street 1:2542 JEFFERSON HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-8502
Mailing Address - Country:US
Mailing Address - Phone:540-943-8545
Mailing Address - Fax:
Practice Address - Street 1:2542 JEFFERSON HWY STE 104
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-8502
Practice Address - Country:US
Practice Address - Phone:540-943-8545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment