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General NPI Number Information
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NPI Number | 1912142282
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Entity Type | Organization
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Legal Business Name | JOHN E. LOFTHUS, DDS, INC.
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 7877 IVANHOE AVE SUITE 2
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City | LA JOLLA
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State | CA
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Zip | 92037-4528
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Country | US
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Telephone | 858-459-4364
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Fax |
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Provider Business Mailing Address
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Address Line | 7877 IVANHOE AVE SUITE 2
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City | LA JOLLA
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State | CA
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Zip | 92037-4528
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Country | US
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Telephone | 858-459-4364
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN E LOFTHUS
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Credential | DDS
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Telephone | 858-459-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 33621
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License Number State | CA
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