Provider Demographics
NPI:1366684672
Name:LOWE & ROSSOPOULOS, D.D.S., INC
Entity Type:Organization
Organization Name:LOWE & ROSSOPOULOS, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-854-9530
Mailing Address - Street 1:802 MAGNOLIA AVE
Mailing Address - Street 2:105
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3104
Mailing Address - Country:US
Mailing Address - Phone:951-371-8833
Mailing Address - Fax:
Practice Address - Street 1:802 MAGNOLIA AVE
Practice Address - Street 2:105
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3104
Practice Address - Country:US
Practice Address - Phone:951-371-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310271223P0221X
CA366051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty