MEDICARE: DAVID W. LOWE D.D.S.,M.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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN13862	FL

General Provider Information

NPI Number	:	1528140670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID W. LOWE D.D.S.,M.S.

Provider Business Mailing Address
First Line	:	4904 S CLYDE MORRIS BLVD
Second Line	:	SUITE A
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-4170
Country	:	US
Telephone Number	:	386-304-0100
Fax Number	:	386-304-4546

Provider Business Practice Location Address
First Line	:	4904 S CLYDE MORRIS BLVD
Second Line	:	SUITE A
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-4170
Country	:	US
Telephone Number	:	386-304-0100
Fax Number	:	386-304-4546

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID W. LOWE D.D.S.,M.S.” Practice Location

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