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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