Kenneth Shane Fowler in Lafayette - Endodontics
Kenneth Shane Fowler - NPI 1518004761
Kenneth Shane Fowler is a Endodontics in Lafayette, Louisiana. Kenneth Shane Fowler practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Kenneth Shane Fowler is 1518004761. The last update date is 2023-03-23.
Kenneth Shane Fowler's current location address is 4906 Ambassador Caffery Pkwy Bldg O, Lafayette, Louisiana. You can contact this provider via phone number 3379810144 and fax number 3379810162. The mailing address for Kenneth Shane Fowler is 4906 Ambassador Caffery Pkwy Bldg O, Lafayette, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Shane Fowler |
|---|---|
| Address | 4906 Ambassador Caffery Pkwy Bldg O, Lafayette, Louisiana |
| Phone Number | 3379810144 |
| Fax Number | 3379810162 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1518004761 |
|---|---|
| Provider Enumeration Date | 2007-01-30 |
| Last Updated Date | 2023-03-23 |
Provider Mailing Address Detail
| Address | 4906 Ambassador Caffery Pkwy Bldg O |
|---|---|
| City | Lafayette |
| State | Louisiana (LA) |
| Post Code | 705086962 |
| Phone Number | 3379810144 |
| Fax Number | 3379810162 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
| Licence No | 5326 |
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Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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What is the unique 10-digit identification code issued to Kenneth Shane Fowler by the Centers for Medicare & Medicaid Services?
The Kenneth Shane Fowler has been assigned the NPI (National Provider Identifier) 1518004761 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Kenneth Shane Fowler?
The Kenneth Shane Fowler is physically situated at 4906 Ambassador Caffery Pkwy Bldg O, in the city of Lafayette, state of LA, with the postal code 705086962.
What is Kenneth Shane Fowler's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kenneth Shane Fowler's specialized field of practice is Endodontics, and the corresponding taxonomy code that categorizes this area of specialization is 1223E0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1518004761 to Kenneth Shane Fowler?
The Centers for Medicare & Medicaid Services originally issued the 1518004761 to Kenneth Shane Fowler on 2007-01-30.
As of what date were the details related to Kenneth Shane Fowler most recently updated or revised?
The information pertaining to Kenneth Shane Fowler, including its address, specialty, and other relevant details, was last updated or revised on 2023-03-23.
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