Provider Demographics
NPI:1295993343
Name:LOWELL, VICTOR ALEXANDER (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ALEXANDER
Last Name:LOWELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SOUTH DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 4J
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2232
Mailing Address - Country:US
Mailing Address - Phone:305-665-7771
Mailing Address - Fax:305-665-7784
Practice Address - Street 1:420 SOUTH DIXIE HIGHWAY
Practice Address - Street 2:SUITE 4J
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2232
Practice Address - Country:US
Practice Address - Phone:305-665-7771
Practice Address - Fax:305-665-7784
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN174511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice