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NPI Code Detail

MEDICARE: DR. JUSTIN LOWREY DYRE D.M.D.

MEDICARE: DR. JUSTIN LOWREY DYRE D.M.D.
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
11223G0001XGeneral Practice Dentistry3634MS

General Provider Information

NPI Number : 1588926570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN LOWREY DYRE D.M.D.
Provider Business Mailing Address
First Line : 459 PEBBLE CREEK DR
Second Line :
City : MADISON
State : MS
Zip : 39110-9191
Country : US
Telephone Number : 601-856-3141
Fax Number : 601-856-1522
Provider Business Practice Location Address
First Line : 1075 LAKE VILLAGE CIR
Second Line :
City : BRANDON
State : MS
Zip : 39047-6743
Country : US
Telephone Number : 601-992-1605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2012
Last Update Date : 05/16/2024

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