| NPI | 1386804185 |
|---|---|
| Former Name | MEAGAN R BOWLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61086) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE Pending) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2016-05-31 |