Organization
AWESOME KIDS DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONTRA LOWE DDS (MANAGER/DENTIST)
(571) 261-2600
Entity
Organization
Contact information
Practice address
6468 TRADING SQ, HAYMARKET, VA 20169-2277
(571) 261-2600
(571) 261-2699
Mailing address
6468 TRADING SQ, HAYMARKET, VA 20169-2277
(571) 261-2600
(571) 261-2699
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411583
VA
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
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