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General NPI Number Information
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NPI Number | 1396964391
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Entity Type | Organization
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Legal Business Name | LOREN K. CHURCHMAN,D.D.S. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 1090 EUGENIA PL STE 100
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City | CARPINTERIA
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State | CA
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Zip | 93013-2011
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Country | US
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Telephone | 805-566-1975
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Fax | 805-566-0082
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Provider Business Mailing Address
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Address Line | 1090 EUGENIA PL STE 100
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City | CARPINTERIA
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State | CA
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Zip | 93013-2011
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Country | US
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Telephone | 805-566-1975
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Fax | 805-566-0082
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOREN K CHURCHMAN
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Credential | DDS
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Telephone | 805-566-1975
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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 | 37644
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License Number State | CA
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