DR. Jason Alan Fowler, D.D.S.
NPI #1417205873 in Great Lakes, Illinois
Provider Information
- NPI Number
- 1417205873
- Entity Type
- Individual
- Name
- DR. Jason Alan Fowler, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- D.D.S.
- Enumeration Date
- Aug 16, 2012
- Last Updated
- Aug 16, 2012
Practice Location
- Address
- 2410 SAMPSON ST
- Address 2
- BLDG. 237
- City
- Great Lakes
- State
- Illinois
- ZIP Code
- 60088-2942
- Phone
- (847) 688-3331
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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