Organization
LOFTUS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUADALUPE GUTIERREZ DMD (DENTIST)
(435) 340-1054
Entity
Organization
Contact information
Practice address
2615 N FRUITLAND LN, COEUR D ALENE, ID 83815-7914
(435) 340-1054
Mailing address
2615 N FRUITLAND LN, COEUR D ALENE, ID 83815-7914
(435) 340-1054
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
D-4664
ID
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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