Provider Demographics
NPI:1114250669
Name:SOWLE, ANDREW CARY (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CARY
Last Name:SOWLE
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 1:1401 N ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:IL
Mailing Address - Zip Code:62454-1003
Mailing Address - Country:US
Mailing Address - Phone:618-546-1544
Mailing Address - Fax:
Practice Address - Street 1:1401 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-1003
Practice Address - Country:US
Practice Address - Phone:618-546-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0253211223G0001X
MO20210087421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice