Provider Demographics
NPI:1326135203
Name:ANDERSON, LOWELL KAYE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:KAYE
Last Name:ANDERSON
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Gender:M
Credentials:DMD
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Mailing Address - Street 1:7138 SO 2000 E
Mailing Address - Street 2:# 211 DR LOWELL ANDERSON
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:801-943-8703
Mailing Address - Fax:801-943-5150
Practice Address - Street 1:181 W VINE
Practice Address - Street 2:DR LOWELL ANDERSON
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074
Practice Address - Country:US
Practice Address - Phone:435-882-8800
Practice Address - Fax:435-882-8954
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT13264699241223S0112X
NVS246C1223S0112X
WY10571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery