Provider Demographics
NPI:1487264776
Name:BOWERS, ANNA (DDS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N ELLSWORTH AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3196
Mailing Address - Country:US
Mailing Address - Phone:502-386-1076
Mailing Address - Fax:
Practice Address - Street 1:420 CAMBRIDGE AVE STE 5
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1594
Practice Address - Country:US
Practice Address - Phone:650-328-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1050301223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics