| Bowers Orthodontic Specialists | |
|
9 Heartland Dr Suite A Bloomington IL 61704-7732 | |
| (309) 663-0415 | |
| (309) 661-0685 |
| Full Name | Bowers Orthodontic Specialists |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9 Heartland Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Kurt T Bowers (OWNER) |
| Authorized Official Contact | 3096630415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bowers Orthodontic Specialists 9 Heartland Dr Suite A Bloomington IL 61704-7732 Ph: (309) 663-0415 | Bowers Orthodontic Specialists 9 Heartland Dr Suite A Bloomington IL 61704-7732 Ph: (309) 663-0415 |
| NPI Number | 1962789842 |
|---|---|
| Provider Enumeration Date | 11/07/2011 |
| Last Update Date | 11/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962789842 | NPI | - | NPPES |
| 019013689 | Medicaid | IL | |
| 021.001647 | Other | IL | ORTHODONTIC LICENSE |
| 019.023201 | Other | IL | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019.023201 (Illinois) | Primary |
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