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Organization
LOFTIN DENTAL, PLLC
Active
Organization
LOFTIN DENTAL, PLLC
Active
Other names
Booneville Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CLAYTON LOFTIN DDS (OWNER)
(405) 203-9862
Entity
Organization
Contact information
Practice address
1057 W MAIN ST, BOONEVILLE, AR 72927-3403
(479) 675-3521
Mailing address
1057 W MAIN ST, BOONEVILLE, AR 72927-3403
(479) 675-3521
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487934543
INDIVIDUAL
—
Enumeration date
05/18/2020
Last updated
05/18/2020
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