Provider Demographics
NPI:1972933570
Name:WILLIAM CRAIG BOWEN DDS, PLLC
Entity type:Organization
Organization Name:WILLIAM CRAIG BOWEN DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-453-3329
Mailing Address - Street 1:366 NORWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-1319
Mailing Address - Country:US
Mailing Address - Phone:304-697-2500
Mailing Address - Fax:304-697-2504
Practice Address - Street 1:366 NORWAY AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-1319
Practice Address - Country:US
Practice Address - Phone:304-697-2500
Practice Address - Fax:304-697-2504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM CRAIG BOWEN DDS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV36361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty