Provider Demographics
NPI:1881886059
Name:ROWLEY, EMERSON TODD (DMD)
Entity type:Individual
Prefix:DR
First Name:EMERSON
Middle Name:TODD
Last Name:ROWLEY
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:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113
Mailing Address - Country:US
Mailing Address - Phone:503-359-0339
Mailing Address - Fax:503-359-5754
Practice Address - Street 1:926 BASLINE RD.
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:OR
Practice Address - Zip Code:97113
Practice Address - Country:US
Practice Address - Phone:503-359-0339
Practice Address - Fax:503-359-5754
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ73351223G0001X
ORD94031223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice