Provider Demographics
NPI:1093971848
Name:ELMORE, BROOKE ZANE LOFTIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ZANE LOFTIS
Last Name:ELMORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 INDIAN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1631
Mailing Address - Country:US
Mailing Address - Phone:972-937-4424
Mailing Address - Fax:972-937-4258
Practice Address - Street 1:111 INDIAN DR STE 101
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1631
Practice Address - Country:US
Practice Address - Phone:972-934-4424
Practice Address - Fax:972-937-4258
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23626122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist