Provider Demographics
NPI:1649730425
Name:GREGORY B LOWENGUTH
Entity type:Organization
Organization Name:GREGORY B LOWENGUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWENGUTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-281-8657
Mailing Address - Street 1:14 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-1114
Mailing Address - Country:US
Mailing Address - Phone:585-624-1917
Mailing Address - Fax:
Practice Address - Street 1:14 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-1114
Practice Address - Country:US
Practice Address - Phone:585-624-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty