| Organization Name: | BOWEN AND THORNLEY DDS PC |
| NPI Number: | 1003865114 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL A BOWEN (PRESIDENT DENTIST) |
| Mailing Address: | 17000 Robbins Rd Grand Haven |
| State: | MI US |
| Postal Code: | 49417 |
| Phone Number: | 6168467360 |
| Fax Number: | 6168462861 |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 01196401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |