Organization
LOWDER ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP DAVID LOWDER D.D.S. M.CL.D. (MANAGER)
(208) 569-8980
Entity
Organization
Contact information
Practice address
1410 E 17TH STREET, IDAHO, ID 83403
(208) 522-4552
Mailing address
1410 E 17TH STREET, IDAHO, ID 83403
(208) 522-4552
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D3600OR
ID
Other
Enumeration date
06/20/2008
Last updated
06/20/2008
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