| Lowder Orthodontics | |
|
1410 E 17th Street Idaho ID 83403 | |
| (208) 522-4552 | |
| Not Available |
| Full Name | Lowder Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1410 E 17th Street, Idaho, Idaho |
| Authorized Official Name and Position | Phillip David Lowder (MANAGER) |
| Authorized Official Contact | 2085698980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lowder Orthodontics 1410 E 17th Street Idaho ID 83403 Ph: (208) 522-4552 | Lowder Orthodontics 1410 E 17th Street Idaho ID 83403 Ph: (208) 522-4552 |
| NPI Number | 1235390345 |
|---|---|
| Provider Enumeration Date | 06/20/2008 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235390345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D3600OR (Idaho) | Primary |