Provider Demographics
NPI:1215599964
Name:LOWRANCE, SHANAE DEANN (DDS)
Entity Type:Individual
Prefix:
First Name:SHANAE
Middle Name:DEANN
Last Name:LOWRANCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4228
Mailing Address - Country:US
Mailing Address - Phone:214-869-6549
Mailing Address - Fax:
Practice Address - Street 1:1350 SUMMER LEE DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-5453
Practice Address - Country:US
Practice Address - Phone:972-771-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice