Provider Demographics
NPI:1194882944
Name:MCGOWAN, PAUL DORDEN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DORDEN
Last Name:MCGOWAN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9925 WESTLAND DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:865-690-0085
Mailing Address - Fax:865-690-1630
Practice Address - Street 1:9925 WESTLAND DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-690-0085
Practice Address - Fax:865-690-1630
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNDS39401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice