Provider Demographics
NPI:1669881678
Name:MCDOWELL, GARRETT
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 LANCASTER AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1290
Mailing Address - Country:US
Mailing Address - Phone:215-850-3491
Mailing Address - Fax:
Practice Address - Street 1:1301 LANCASTER AVE STE 208
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1290
Practice Address - Country:US
Practice Address - Phone:610-251-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040130122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No122300000XDental ProvidersDentist