Provider Demographics
NPI:1588926570
Name:DYRE, JUSTIN LOWREY (DMD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:LOWREY
Last Name:DYRE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9191
Mailing Address - Country:US
Mailing Address - Phone:601-856-3141
Mailing Address - Fax:601-856-1522
Practice Address - Street 1:1075 LAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-6743
Practice Address - Country:US
Practice Address - Phone:601-992-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS36341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice