Individual
PHILLIP DAVID LOWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.CL.D
Contact information
Practice address
250 SOUTH SKYINE DRIVE, STE 4, IDAHO FALLS, ID 83402
(208) 524-1404
(208) 524-1114
Mailing address
1002 SHELL FLOWER RD, HENDERSON, NV 89074-8049
(702) 451-4205
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D3600-OR
ID
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S3100
NV
Other
Enumeration date
02/15/2007
Last updated
03/28/2019
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