Provider Demographics
NPI:1912492513
Name:BOWERS, JOSHUA (DMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BOWERS
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 1:1543 N ELMS RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2034
Mailing Address - Country:US
Mailing Address - Phone:810-845-9305
Mailing Address - Fax:
Practice Address - Street 1:1543 N ELMS RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-2034
Practice Address - Country:US
Practice Address - Phone:810-230-8477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010226761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice