Provider Demographics
NPI:1447274923
Name:LIFETIME DENTAL CARE, PA
Entity type:Organization
Organization Name:LIFETIME DENTAL CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HUGHWAYNE
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-625-7969
Mailing Address - Street 1:2701 STERNBERG DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601
Mailing Address - Country:US
Mailing Address - Phone:785-625-7969
Mailing Address - Fax:785-625-4441
Practice Address - Street 1:2701 STERNBERG DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601
Practice Address - Country:US
Practice Address - Phone:785-625-7969
Practice Address - Fax:785-625-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS70671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty