MEDICARE: DR. LAWRENCE ALLEN LOWE D.D.S.

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	29835	CA

General Provider Information

NPI Number	:	1841377546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE ALLEN LOWE D.D.S.

Provider Business Mailing Address
First Line	:	5646 N PALM AVE
Second Line	:	SUITE 104
City	:	FRESNO
State	:	CA
Zip	:	93704-1848
Country	:	US
Telephone Number	:	559-431-3002
Fax Number	:	559-431-3352

Provider Business Practice Location Address
First Line	:	5646 N PALM AVE
Second Line	:	SUITE 104
City	:	FRESNO
State	:	CA
Zip	:	93704-1848
Country	:	US
Telephone Number	:	559-431-3002
Fax Number	:	559-431-3352

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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