NPI 1902949969 · live from the CMS NPI Registry
Phillip David Lowder, D.D.S., M.Cl.D
Dentist, Orthodontics and Dentofacial Orthopedics in Idaho Falls, ID. National Provider Identifier 1902949969, active.
NPI record
| NPI | 1902949969 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 250 South Skyine Drive, Ste 4, Idaho Falls, ID 83402 |
| Practice phone | 208-524-1404 |
| Mailing address | 1002 Shell Flower Rd, Henderson, NV 89074 |
| Enumerated | February 15, 2007 |
| Last updated | March 28, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | S3100 (NV) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D3600-OR (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.