Provider Demographics
NPI:1962777250
Name:NANCY J. COWELL, D.M.D.
Entity type:Organization
Organization Name:NANCY J. COWELL, D.M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:COWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:620-879-2386
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:CANEY
Mailing Address - State:KS
Mailing Address - Zip Code:67333-0008
Mailing Address - Country:US
Mailing Address - Phone:620-879-2386
Mailing Address - Fax:620-879-5651
Practice Address - Street 1:101 S MCGEE ST
Practice Address - Street 2:
Practice Address - City:CANEY
Practice Address - State:KS
Practice Address - Zip Code:67333-2179
Practice Address - Country:US
Practice Address - Phone:620-879-2386
Practice Address - Fax:620-879-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS601711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty