Provider Demographics
NPI:1508987280
Name:LOWE, ROBERT A (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:LOWE
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6836 MORRISON BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2612
Mailing Address - Country:US
Mailing Address - Phone:704-450-3321
Mailing Address - Fax:
Practice Address - Street 1:2809 COLTSGATE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5582
Practice Address - Country:US
Practice Address - Phone:704-364-4711
Practice Address - Fax:704-364-1963
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice