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General NPI Number Information
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NPI Number | 1366684672
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Entity Type | Organization
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Legal Business Name | LOWE & ROSSOPOULOS, D.D.S., INC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 802 MAGNOLIA AVE 105
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City | CORONA
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State | CA
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Zip | 92879-3104
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Country | US
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Telephone | 951-371-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 802 MAGNOLIA AVE 105
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City | CORONA
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State | CA
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Zip | 92879-3104
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Country | US
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Telephone | 951-371-8833
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | EVANGELOS ROSSOPOULOS
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Credential |
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Telephone | 626-854-9530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 36605
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 31027
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License Number State | CA
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