Provider Demographics
NPI:1568556678
Name:LOTH, DEBORAH C (D D S, M S)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:LOTH
Suffix:
Gender:F
Credentials:D D S, M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 MATLOCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2529
Mailing Address - Country:US
Mailing Address - Phone:817-738-0999
Mailing Address - Fax:817-274-8220
Practice Address - Street 1:2755 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2529
Practice Address - Country:US
Practice Address - Phone:817-261-8220
Practice Address - Fax:817-274-8220
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics