MEDICARE: DR. KETURAH L LOWE 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	1223G0001X	General Practice Dentistry	0585841	NY
2	1223P0221X	Pediatric Dentistry	16468	MD

General Provider Information

NPI Number	:	1396122248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KETURAH L LOWE DDS

Provider Business Mailing Address
First Line	:	845 QUINCE ORCHARD BLVD STE H
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-1676
Country	:	US
Telephone Number	:	301-527-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 QUINCE ORCHARD BLVD STE H
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-1676
Country	:	US
Telephone Number	:	301-527-2727
Fax Number	:

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

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	03/06/2023

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