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NPI 1780635821

NPI 1780635821 : SAMANTHA R LOWE D.D.S. : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1780635821
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    Entity Type          |    Individual 
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    Provider Name        |    SAMANTHA R LOWE D.D.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/13/2006
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    Last Update Date     |    08/20/2019
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Provider Practice Location Address
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    Address Line         |    2802 LAFAYETTE ROAD SUITE 33
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46222
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    Country              |    US
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    Telephone            |    317-925-2810
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    Fax                  |    317-925-2780
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Provider Business Mailing Address
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    Address Line         |    2802 LAFAYETTE ROAD SUITE 33
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46222
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    Country              |    US
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    Telephone            |    317-925-2810
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    Fax                  |    719-583-1801
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    12010007A
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    License Number State |    IN
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