Individual
MICHAEL J LOFTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10101 ACADEMY RD, SUITE 203, PHILADELPHIA, PA 19114-1120
(215) 281-3400
(215) 281-3477
Mailing address
10101 ACADEMY RD., SUITE 203, PHILADELPHIA, PA 19114-1120
(215) 281-3400
(215) 281-3477
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DS-020530-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060844000
KEYSTONE
PA
01
—
023312
PERSONAL CHOICE
PA
01
—
2220900
AETNA
PA
Enumeration date
09/21/2006
Last updated
11/05/2021
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