Provider Demographics
NPI:1841376811
Name:JOSEPH CRAIG COWAN DDS, INC.
Entity type:Organization
Organization Name:JOSEPH CRAIG COWAN DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-872-7664
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:LAMESA
Mailing Address - State:TX
Mailing Address - Zip Code:79331-0541
Mailing Address - Country:US
Mailing Address - Phone:806-872-7664
Mailing Address - Fax:806-872-5334
Practice Address - Street 1:706 SOUTH FIRST STREET
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-0541
Practice Address - Country:US
Practice Address - Phone:806-872-7664
Practice Address - Fax:806-872-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty