Provider Demographics
NPI:1457406126
Name:BOWMAN, RICHARD (DDS DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DDS DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26012 175 AVE SE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042
Mailing Address - Country:US
Mailing Address - Phone:206-898-9756
Mailing Address - Fax:
Practice Address - Street 1:17306 SMOKEY PT DR
Practice Address - Street 2:#21
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-658-7741
Practice Address - Fax:360-658-7806
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000080291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics