Provider Demographics
NPI:1447827936
Name:ENHANCE DENTAL OF ALLEN
Entity type:Organization
Organization Name:ENHANCE DENTAL OF ALLEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-326-8004
Mailing Address - Street 1:2730 COUNTRY CLUB RD STE C
Mailing Address - Street 2:
Mailing Address - City:LUCAS
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8781
Mailing Address - Country:US
Mailing Address - Phone:972-456-9220
Mailing Address - Fax:
Practice Address - Street 1:2730 COUNTRY CLUB RD STE C
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8781
Practice Address - Country:US
Practice Address - Phone:972-456-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental