Provider Demographics
NPI:1023543188
Name:LOWERY DENTAL GROUP PC
Entity Type:Organization
Organization Name:LOWERY DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VASCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:706-886-8472
Mailing Address - Street 1:31 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:EASTANOLLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30538-3213
Mailing Address - Country:US
Mailing Address - Phone:706-886-8472
Mailing Address - Fax:706-886-5664
Practice Address - Street 1:31 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:EASTANOLLEE
Practice Address - State:GA
Practice Address - Zip Code:30538-3213
Practice Address - Country:US
Practice Address - Phone:706-886-8472
Practice Address - Fax:706-886-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty