| Lynn R Bowen Dds Pc | |
|
210 W South St Lagrange IN 46761-2233 | |
| (260) 463-7006 | |
| (260) 463-4135 |
| Full Name | Lynn R Bowen Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 210 W South St, Lagrange, Indiana |
| Authorized Official Name and Position | Lynn R Bowen (PRESIDENT) |
| Authorized Official Contact | 2604637006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn R Bowen Dds Pc 210 W South St Lagrange IN 46761-2233 Ph: (260) 463-7006 | Lynn R Bowen Dds Pc 210 W South St Lagrange IN 46761-2233 Ph: (260) 463-7006 |
| NPI Number | 1164729851 |
|---|---|
| Provider Enumeration Date | 02/16/2011 |
| Last Update Date | 02/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164729851 | NPI | - | NPPES |
| 200956730A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12008550A (Indiana) | Primary |
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