Provider Demographics
NPI:1609417062
Name:RONNIE LOWERY, D.D.S., PC
Entity Type:Organization
Organization Name:RONNIE LOWERY, D.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ENDORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-785-1037
Mailing Address - Street 1:PO BOX 877
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-0877
Mailing Address - Country:US
Mailing Address - Phone:910-521-6065
Mailing Address - Fax:910-521-6021
Practice Address - Street 1:132 NEW HORIZONS DRIVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-2837
Practice Address - Country:US
Practice Address - Phone:910-521-6065
Practice Address - Fax:910-521-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty