Provider Demographics
NPI:1750460176
Name:RONALD J. KOWAN D.D.S.,P.C.
Entity type:Organization
Organization Name:RONALD J. KOWAN D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:706-327-2143
Mailing Address - Street 1:1218 PEACOCK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2425
Mailing Address - Country:US
Mailing Address - Phone:706-327-2143
Mailing Address - Fax:706-327-7114
Practice Address - Street 1:1218 PEACOCK AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2425
Practice Address - Country:US
Practice Address - Phone:706-327-2143
Practice Address - Fax:706-327-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-05
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty