| Sidney J. Fowler, D.d.s. | |
|
1023 N Mound St Suite D Nacogdoches TX 75961-4491 | |
| (936) 564-9401 | |
| Not Available |
| Full Name | Sidney J. Fowler, D.d.s. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1023 N Mound St, Nacogdoches, Texas |
| Authorized Official Name and Position | Kim A Fowler (OWNER/ OFFICE MANAGER) |
| Authorized Official Contact | 9365649401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sidney J. Fowler, D.d.s. 1023 N Mound St Suite D Nacogdoches TX 75961-4491 Ph: (936) 564-9401 | Sidney J. Fowler, D.d.s. 1023 N Mound St Suite D Nacogdoches TX 75961-4491 Ph: (936) 564-9401 |
| NPI Number | 1659539708 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659539708 | NPI | - | NPPES |
| 172282901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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