Provider Demographics
NPI:1104058429
Name:J. JOEL LOWRY D.D.S., INC.
Entity type:Organization
Organization Name:J. JOEL LOWRY D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-552-5477
Mailing Address - Street 1:2122 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-4452
Mailing Address - Country:US
Mailing Address - Phone:940-552-5477
Mailing Address - Fax:940-552-6677
Practice Address - Street 1:2122 TEXAS ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-4452
Practice Address - Country:US
Practice Address - Phone:940-552-5477
Practice Address - Fax:940-552-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty