Provider Demographics
NPI:1346441219
Name:FLOR D. LOYA, D.D.S., LTD
Entity Type:Organization
Organization Name:FLOR D. LOYA, D.D.S., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOYA-COSTABILE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-344-5437
Mailing Address - Street 1:154 N 19TH AVE
Mailing Address - Street 2:200
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-3718
Mailing Address - Country:US
Mailing Address - Phone:708-344-5437
Mailing Address - Fax:708-344-5437
Practice Address - Street 1:154 N 19TH AVE
Practice Address - Street 2:200
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-3718
Practice Address - Country:US
Practice Address - Phone:708-344-5437
Practice Address - Fax:708-344-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Single Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty