Provider Demographics
NPI:1497819833
Name:LOWE, MARK (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 N FRESNO ST STE 203
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2957
Mailing Address - Country:US
Mailing Address - Phone:559-435-0966
Mailing Address - Fax:559-435-5851
Practice Address - Street 1:7055 N FRESNO ST STE 203
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2957
Practice Address - Country:US
Practice Address - Phone:559-435-0966
Practice Address - Fax:559-435-5851
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36676 CA1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics