Provider Demographics
NPI:1063905636
Name:BOWCUTT, DANIEL A (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:BOWCUTT
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 1:2030 HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2176
Mailing Address - Country:US
Mailing Address - Phone:254-870-3221
Mailing Address - Fax:
Practice Address - Street 1:2030 HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2176
Practice Address - Country:US
Practice Address - Phone:254-870-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34077OtherTEXAS