Dental Board of California
Licensing details for: 10806
Name: FOWLER ORTHODONTICS, DENTAL OFFICE OF DR. BRANDON FOWLER
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: FOWLER ORTHODONTICS DENTAL OFFICE OF DR. BRANDON FOWLER
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FOWLER, BRANDON BOEKAMP
Address Not Disclosed
FNP to DDS or OMS
License/Registration Role: Fictitious Name Permit
Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Name: FOWLER, BRANDON BOEKAMP
License/Registration Type: Dentist License
License Number: 57470 Primary Status: Expired
Address :
1718 S Millenium Way
MERIDIAN ID 83642-1511
ADA COUNTY
