Provider Demographics
NPI:1255975819
Name:TOWLE DENTAL CORPORATION
Entity type:Organization
Organization Name:TOWLE DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELVA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BICKNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-933-5677
Mailing Address - Street 1:2229 OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1623
Mailing Address - Country:US
Mailing Address - Phone:925-933-5677
Mailing Address - Fax:925-939-7650
Practice Address - Street 1:2229 OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-1623
Practice Address - Country:US
Practice Address - Phone:925-933-5677
Practice Address - Fax:925-939-7650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty