Provider Demographics
NPI:1487808184
Name:ROWE, MICHAEL WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:ROWE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5121 EHRLICH RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2049
Mailing Address - Country:US
Mailing Address - Phone:813-968-9641
Mailing Address - Fax:813-960-7647
Practice Address - Street 1:5121 EHRLICH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2049
Practice Address - Country:US
Practice Address - Phone:813-968-9641
Practice Address - Fax:813-960-7647
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN82521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics