Healthcare Provider Details

I. General information

NPI: 1205246493
Provider Name (Legal Business Name): LOYNES DENTAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1196 PINE GROVE RD
TALLAPOOSA GA
30176-3137
US

IV. Provider business mailing address

1196 PINE GROVE RD P O BOX 275
TALLAPOOSA GA
30176-3137
US

V. Phone/Fax

Practice location:
  • Phone: 770-574-2812
  • Fax: 770-574-5020
Mailing address:
  • Phone: 770-574-2812
  • Fax: 770-574-5020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. MURGESH J LOYNES
Title or Position: OWNER
Credential: D.D.S.
Phone: 770-574-2812