Provider Demographics
NPI:1841638525
Name:BOWEN, NATHAN DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:DANIEL
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5469 S STATE HIGHWAY FF
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-9825
Mailing Address - Country:US
Mailing Address - Phone:702-283-8421
Mailing Address - Fax:
Practice Address - Street 1:5469 S STATE HIGHWAY FF
Practice Address - Street 2:
Practice Address - City:BATTLEFIELD
Practice Address - State:MO
Practice Address - Zip Code:65619-9825
Practice Address - Country:US
Practice Address - Phone:417-447-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6524122300000X
MO2021001967122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist