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General NPI Number Information
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NPI Number | 1619435906
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Entity Type | Organization
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Legal Business Name | LOVELAND DENTAL GROUP OF MOORESVILLE
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 134 N. MAGNOLIA STREET
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City | MOORESVILLE
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State | NC
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Zip | 28115
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Country | US
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Telephone | 704-980-9055
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Fax | 980-444-9196
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Provider Business Mailing Address
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Address Line | 134 N. MAGNOLIA STREET
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City | MOORESVILLE
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State | NC
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Zip | 28115
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Country | US
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Telephone | 704-980-9055
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Fax | 980-444-9196
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER ANN LOVELAND
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Credential | DMD
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Telephone | 704-997-1835
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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 |
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