Provider Demographics
NPI:1841377546
Name:LOWE, LAWRENCE ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALLEN
Last Name:LOWE
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 1:5646 N PALM AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1848
Mailing Address - Country:US
Mailing Address - Phone:559-431-3002
Mailing Address - Fax:559-431-3352
Practice Address - Street 1:5646 N PALM AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1848
Practice Address - Country:US
Practice Address - Phone:559-431-3002
Practice Address - Fax:559-431-3352
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29835122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist