Organization
STUART LOOS DDD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SALLY J LOOS (MANAGER)
(770) 345-8300
Entity
Organization
Contact information
Practice address
1353 RIVERSTONE PKWY, SUITE 130, CANTON, GA 30114-5634
(770) 345-8300
(770) 345-8305
Mailing address
1353 RIVERSTONE PKWY, SUITE 130, CANTON, GA 30114-5634
(770) 345-8300
(770) 345-8305
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10100
GA
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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