MEDICARE: DR. LESTER H LOW 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	122300000X	Dentist	34736	CA

General Provider Information

NPI Number	:	1841293669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESTER H LOW DDS

Provider Business Mailing Address
First Line	:	3133 W MARCH LN
Second Line	:	STE 1090
City	:	STOCKTON
State	:	CA
Zip	:	95219-2361
Country	:	US
Telephone Number	:	209-474-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	3133 W MARCH LN
Second Line	:	STE 1090
City	:	STOCKTON
State	:	CA
Zip	:	95219-2361
Country	:	US
Telephone Number	:	209-474-3333
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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