Provider Demographics
NPI:1558540005
Name:LOVATO, ELOISA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELOISA
Middle Name:MARIA
Last Name:LOVATO
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 1:3200 S WADSWORTH BLVD
Mailing Address - Street 2:UNIT E
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5022
Mailing Address - Country:US
Mailing Address - Phone:303-716-8546
Mailing Address - Fax:
Practice Address - Street 1:3200 S WADSWORTH BLVD
Practice Address - Street 2:UNIT E
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5022
Practice Address - Country:US
Practice Address - Phone:303-716-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice