Provider Demographics
NPI:1114192234
Name:LOWRY, EDWARD I (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:I
Last Name:LOWRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LINCOLN WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2570
Mailing Address - Country:US
Mailing Address - Phone:208-765-3322
Mailing Address - Fax:208-765-1024
Practice Address - Street 1:1800 LINCOLN WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2570
Practice Address - Country:US
Practice Address - Phone:208-765-3322
Practice Address - Fax:208-765-1024
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD15281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDCS2054OtherIDAHO STATE BOARD OF PHARMACY #