Provider Demographics
NPI:1982820601
Name:LOWERY, VASCO. ALEXANDER III (DMD)
Entity Type:Individual
Prefix:DR
First Name:VASCO.
Middle Name:ALEXANDER
Last Name:LOWERY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 MEMORIAL DR
Mailing Address - Street 2:MEMORIAL DRIVE
Mailing Address - City:EASTANOLLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30538-3213
Mailing Address - Country:US
Mailing Address - Phone:706-886-8472
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 408
Practice Address - Street 2:MEMORIAL DRIVE
Practice Address - City:EASTANOLLEE
Practice Address - State:GA
Practice Address - Zip Code:30538-9523
Practice Address - Country:US
Practice Address - Phone:706-886-8472
Practice Address - Fax:706-886-5664
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN010807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist