Provider Demographics
NPI:1780702274
Name:BOWMAN, TOMMY CURTIS (DDS)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:CURTIS
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3765 CROSSINGS DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305
Mailing Address - Country:US
Mailing Address - Phone:928-445-8503
Mailing Address - Fax:928-445-3268
Practice Address - Street 1:3765 CROSSINGS DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305
Practice Address - Country:US
Practice Address - Phone:928-445-8503
Practice Address - Fax:928-445-3268
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD48301223G0001X
AZDO4830122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice