| Douglas L. Fowler, Dds, Pllc | |
|
2520 N College Rd Wilmington NC 28405-8808 | |
| (910) 790-3836 | |
| (910) 790-5026 |
| Full Name | Douglas L. Fowler, Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2520 N College Rd, Wilmington, North Carolina |
| Authorized Official Name and Position | Douglas Lane Fowler (OWNER) |
| Authorized Official Contact | 9107903836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas L. Fowler, Dds, Pllc 2520 N College Rd Wilmington NC 28405-8808 Ph: (910) 790-3836 | Douglas L. Fowler, Dds, Pllc 2520 N College Rd Wilmington NC 28405-8808 Ph: (910) 790-3836 |
| NPI Number | 1063557932 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063557932 | NPI | - | NPPES |
| 89902HW | Medicaid | NC | |
| 89016MP | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5355 (North Carolina) | Primary |
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