Provider Demographics
NPI:1831466713
Name:BOWEN, ALLEN JULIAN (DMD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:JULIAN
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 US HIGHWAY 441 N
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-0343
Mailing Address - Country:US
Mailing Address - Phone:478-275-0527
Mailing Address - Fax:
Practice Address - Street 1:2128 US HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-0343
Practice Address - Country:US
Practice Address - Phone:478-275-0527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice