Provider Demographics
NPI:1366708729
Name:BOWER, THOMAS J (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:BOWER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7348
Mailing Address - Country:US
Mailing Address - Phone:978-372-0600
Mailing Address - Fax:978-374-6148
Practice Address - Street 1:323 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:MA
Practice Address - Zip Code:01835-7348
Practice Address - Country:US
Practice Address - Phone:978-372-0600
Practice Address - Fax:978-374-6148
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice