Provider Demographics
NPI:1780635821
Name:LOWE, SAMANTHA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:R
Last Name:LOWE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 LAFAYETTE ROAD
Mailing Address - Street 2:SUITE 33
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222
Mailing Address - Country:US
Mailing Address - Phone:317-925-2810
Mailing Address - Fax:719-583-1801
Practice Address - Street 1:2802 LAFAYETTE ROAD
Practice Address - Street 2:SUITE 33
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222
Practice Address - Country:US
Practice Address - Phone:317-925-2810
Practice Address - Fax:317-925-2780
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010007A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice