Provider Demographics
NPI:1538224027
Name:BOWSER, MICHAEL WILEY JR (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILEY
Last Name:BOWSER
Suffix:JR
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 1:1595 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1256
Mailing Address - Country:US
Mailing Address - Phone:717-846-9428
Mailing Address - Fax:717-846-4994
Practice Address - Street 1:1595 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1256
Practice Address - Country:US
Practice Address - Phone:717-846-9428
Practice Address - Fax:717-846-4994
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019903L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice