Provider Demographics
NPI:1003363565
Name:CRAIG. R. LOWRIE, LLC DBA ADVANCED FAMILY DENTISTRY
Entity Type:Organization
Organization Name:CRAIG. R. LOWRIE, LLC DBA ADVANCED FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LOWRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-357-5018
Mailing Address - Street 1:1401 S SEWARD MERIDIAN PKWY
Mailing Address - Street 2:E
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8312
Mailing Address - Country:US
Mailing Address - Phone:907-357-5018
Mailing Address - Fax:907-864-1091
Practice Address - Street 1:1401 S SEWARD MERIDIAN PKWY
Practice Address - Street 2:E
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8312
Practice Address - Country:US
Practice Address - Phone:907-357-5018
Practice Address - Fax:907-864-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty