Provider Demographics
NPI:1033116041
Name:LOYD, MARVIN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:D
Last Name:LOYD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-0743
Mailing Address - Country:US
Mailing Address - Phone:870-265-2111
Mailing Address - Fax:870-265-2112
Practice Address - Street 1:403 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1731
Practice Address - Country:US
Practice Address - Phone:870-265-2111
Practice Address - Fax:870-265-2112
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice