Provider Demographics
NPI:1831204403
Name:BOWMAN, LAURA HAMM (LAURA BOWMAN)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:HAMM
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LAURA BOWMAN
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:HAMM
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAURA BOWMAN
Mailing Address - Street 1:14 N FORT THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1517
Mailing Address - Country:US
Mailing Address - Phone:859-441-1696
Mailing Address - Fax:859-441-1896
Practice Address - Street 1:14 N FORT THOMAS AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1517
Practice Address - Country:US
Practice Address - Phone:859-441-1696
Practice Address - Fax:859-441-1896
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY57091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice