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General NPI Number Information
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NPI Number | 1316110380
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Entity Type | Organization
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Legal Business Name | TERRENCE P. LOOBY, D.D.S.
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 1800 W LAKE ST
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City | MELROSE PARK
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State | IL
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Zip | 60160-3732
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Country | US
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Telephone | 708-345-5505
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Fax | 705-345-8338
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Provider Business Mailing Address
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Address Line | 1800 W LAKE ST
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City | MELROSE PARK
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State | IL
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Zip | 60160-3732
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Country | US
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Telephone | 708-345-5505
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Fax | 705-345-8338
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRENCE PATRICK LOOBY
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Credential | D.D.S.
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Telephone | 773-844-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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