Provider Demographics
NPI:1962780460
Name:BOWERS, CHRISTOPHER WALDEN (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WALDEN
Last Name:BOWERS
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 1:257 GOLD ST PH N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2085
Mailing Address - Country:US
Mailing Address - Phone:843-906-8608
Mailing Address - Fax:718-855-1426
Practice Address - Street 1:567 PACIFIC ST
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1121
Practice Address - Country:US
Practice Address - Phone:843-906-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0555891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice