Organization
JEFFREY D LOVELESS DDS PA
Active
Organization
JEFFREY D LOVELESS DDS PA
Active
Other names
Prairie Ridge Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DONALD LOVELESS DDS MS (PRESIDENT)
(507) 451-5993
Entity
Organization
Contact information
Practice address
475 26TH ST NE, OWATONNA, MN 55060
(507) 451-5993
(507) 451-5856
Mailing address
475 26TH STREET NE, OWATONNA, MN 55060
(507) 451-5993
(507) 451-5856
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11146
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9179850
DORAL DENTAL
MN
01
—
MHCP715324400
MN DEPT HUMAN SERVICES
MN
Enumeration date
04/22/2008
Last updated
04/22/2008
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