Provider Demographics
NPI:1538732532
Name:BOWDEN, CARSON SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:CARSON
Middle Name:SCOTT
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 E COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4611
Mailing Address - Country:US
Mailing Address - Phone:509-765-7853
Mailing Address - Fax:509-765-7552
Practice Address - Street 1:823 E COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4611
Practice Address - Country:US
Practice Address - Phone:509-765-7853
Practice Address - Fax:509-765-7552
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE611897801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice