Provider Demographics
NPI:1396930186
Name:BOWER, ASHLEE LAUREN (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:LAUREN
Last Name:BOWER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ASHLEE
Other - Middle Name:LAUREN
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:901 LAMBERTON SUITE W
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107
Mailing Address - Country:US
Mailing Address - Phone:505-323-1300
Mailing Address - Fax:505-323-1400
Practice Address - Street 1:901 LAMBERTON PL NE STE W
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1659
Practice Address - Country:US
Practice Address - Phone:505-323-1300
Practice Address - Fax:505-323-1400
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD2941122300000X
AZ7389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist