Provider Demographics
NPI:1306908892
Name:ROWEAN, FAITH A (DDS)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:A
Last Name:ROWEAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12565 E D AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49012-9716
Mailing Address - Country:US
Mailing Address - Phone:269-323-3311
Mailing Address - Fax:269-323-0162
Practice Address - Street 1:710 WEST CENTRE AVENUE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024
Practice Address - Country:US
Practice Address - Phone:269-323-3311
Practice Address - Fax:269-323-0162
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI141311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice