Provider Demographics
NPI:1932258027
Name:BOWMAN, ROBERT WALTER (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WALTER
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SECOND AVENUE WEST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-752-8888
Mailing Address - Fax:406-257-0049
Practice Address - Street 1:22 SECOND AVENUE WEST
Practice Address - Street 2:SUITE 3000
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-752-8888
Practice Address - Fax:406-257-0049
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist