Provider Demographics
NPI:1215959671
Name:ROWE, DUSTIN L (DDS)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:L
Last Name:ROWE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3320 N LOS COYOTES DIAGONAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3918
Mailing Address - Country:US
Mailing Address - Phone:562-496-0111
Mailing Address - Fax:562-496-1773
Practice Address - Street 1:3320 N LOS COYOTES DIAGONAL
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3918
Practice Address - Country:US
Practice Address - Phone:562-496-0111
Practice Address - Fax:562-496-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA382211223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery