| C Douglas Fowler DDS Inc | |
|
6850 Brockton Avenue Suite 103 Riverside CA 92506-3826 | |
| (951) 686-5301 | |
| (951) 686-4375 |
| Full Name | C Douglas Fowler DDS Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 6850 Brockton Avenue, Riverside, California |
| Authorized Official Name and Position | Charles Douglas Fowler (PRESIDENT) |
| Authorized Official Contact | 9516865301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C Douglas Fowler DDS Inc 6850 Brockton Avenue Suite 103 Riverside CA 92506-3826 Ph: (951) 686-5301 | C Douglas Fowler DDS Inc 6850 Brockton Avenue Suite 103 Riverside CA 92506-3826 Ph: (951) 686-5301 |
| NPI Number | 1013035153 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013035153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 19067 (California) | Primary |
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