Provider Demographics
NPI:1386804185
Name:BOWLES, MEAGAN R (DDS)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:R
Last Name:BOWLES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:R
Other - Last Name:BOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7517 GROVER STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-554-4439
Mailing Address - Fax:
Practice Address - Street 1:2503 S 140TH CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2315
Practice Address - Country:US
Practice Address - Phone:402-333-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEPENDING122300000X
KS61086122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist