Provider Demographics
NPI:1245204148
Name:LOWE, MATTHEW C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:LOWE
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 1:2711 S ROUSE ST
Mailing Address - Street 2:A
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6620
Mailing Address - Country:US
Mailing Address - Phone:620-230-0035
Mailing Address - Fax:620-230-0036
Practice Address - Street 1:2711 S ROUSE ST
Practice Address - Street 2:A
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6620
Practice Address - Country:US
Practice Address - Phone:620-230-0035
Practice Address - Fax:620-230-0036
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6736174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS129500OtherUMWA
KS6736OtherDELTA DENTAL
KS017456OtherBLUE CROSS BLUE SHIELD
KS190009606OtherRAILROAD MEDICARE
KS523865OtherUNITED CONCORDIA
KS017456OtherBLUE CROSS BLUE SHIELD
KS190009606OtherRAILROAD MEDICARE