MEDICARE: DR. GARY PAUL LOW DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6656	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0185348	OTHER	IA	TITLE XIX PROVIDER NUMBER
2	6656	OTHER	IA	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1730266305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY PAUL LOW DDS

Provider Business Mailing Address
First Line	:	814 7TH AVE
Second Line	:
City	:	CAMANCHE
State	:	IA
Zip	:	52730-1811
Country	:	US
Telephone Number	:	563-259-1431
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 7TH AVE
Second Line	:
City	:	CAMANCHE
State	:	IA
Zip	:	52730-1811
Country	:	US
Telephone Number	:	563-259-1431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/29/2015

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