Individual
JUAN CARLOS LOYOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 1ST AVE, NEW YORK, NY 10029-7494
(410) 905-1723
Mailing address
116 BRUNK RD, REISTERSTOWN, MD 21136-2322
(410) 905-1723
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
228751
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2022
Last updated
05/09/2024
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