Provider Demographics
NPI:1568671717
Name:GERALD ROWE DMD PC
Entity type:Organization
Organization Name:GERALD ROWE DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:BS DMD
Authorized Official - Phone:307-635-6300
Mailing Address - Street 1:229 STOREY BLVD
Mailing Address - Street 2:A
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009
Mailing Address - Country:US
Mailing Address - Phone:307-635-6300
Mailing Address - Fax:
Practice Address - Street 1:229 STOREY BLVD
Practice Address - Street 2:A
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009
Practice Address - Country:US
Practice Address - Phone:307-635-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty