Provider Demographics
NPI:1316128630
Name:LOWERY, SITI AISHA (DDS)
Entity type:Individual
Prefix:
First Name:SITI
Middle Name:AISHA
Last Name:LOWERY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PRESTON EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513
Mailing Address - Country:US
Mailing Address - Phone:919-468-5501
Mailing Address - Fax:919-468-5594
Practice Address - Street 1:110 PRESTON EXECUTIVE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513
Practice Address - Country:US
Practice Address - Phone:919-468-5501
Practice Address - Fax:919-468-5594
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist