Individual
ERIC TODD LOBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15397 STATE HIGHWAY 32, LAKEWOOD, WI 54138-9702
(715) 276-6321
(715) 276-1428
Mailing address
1907 DEXTER ST, NEW LONDON, WI 54961-2523
(920) 531-1479
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5234-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337-63800
—
WI
Enumeration date
05/27/2005
Last updated
03/07/2023
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