Provider Demographics
NPI:1124450747
Name:DOWDY, TAMRA (RDH)
Entity type:Individual
Prefix:
First Name:TAMRA
Middle Name:
Last Name:DOWDY
Suffix:
Gender:F
Credentials:RDH
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 1685
Mailing Address - Street 2:
Mailing Address - City:BARROW
Mailing Address - State:AK
Mailing Address - Zip Code:99723-1685
Mailing Address - Country:US
Mailing Address - Phone:907-444-6811
Mailing Address - Fax:
Practice Address - Street 1:101 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RAINIER
Practice Address - State:OR
Practice Address - Zip Code:97048-2634
Practice Address - Country:US
Practice Address - Phone:907-444-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2280124Q00000X
AK2026124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist