Provider Demographics
NPI:1033130307
Name:LOOMAR, DAVID A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:LOOMAR
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 1:1901 N OLDEN AVENUE EXT
Mailing Address - Street 2:11A
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2111
Mailing Address - Country:US
Mailing Address - Phone:609-771-9202
Mailing Address - Fax:609-771-9201
Practice Address - Street 1:1901 N OLDEN AVENUE EXT
Practice Address - Street 2:11A
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-2111
Practice Address - Country:US
Practice Address - Phone:609-771-9202
Practice Address - Fax:609-771-9201
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ72881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice