MEDICARE: DEBORAH C LOTH D. D. S., M. S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	15027	TX

General Provider Information

NPI Number	:	1568556678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH C LOTH D. D. S., M. S.

Provider Business Mailing Address
First Line	:	2755 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2529
Country	:	US
Telephone Number	:	817-738-0999
Fax Number	:	817-274-8220

Provider Business Practice Location Address
First Line	:	2755 MATLOCK RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2529
Country	:	US
Telephone Number	:	817-261-8220
Fax Number	:	817-274-8220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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