Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN012990 | GA |
NPI | 1265600654 |
---|---|
Provider Name | Dr. Kevin Allen Lowden |
First Address | Atlanta, GA 30028 |
Second Address | Atlanta, GA 30028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 19/02/2008 |