Provider Demographics
NPI:1639290810
Name:LOWRANCE, STAN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:STAN
Middle Name:D
Last Name:LOWRANCE
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 1:2313 RIDGE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5141
Mailing Address - Country:US
Mailing Address - Phone:972-771-9036
Mailing Address - Fax:972-771-0355
Practice Address - Street 1:2313 RIDGE RD STE 104
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5141
Practice Address - Country:US
Practice Address - Phone:972-771-9036
Practice Address - Fax:972-771-0355
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice