Provider Demographics
NPI:1659382760
Name:BETH A. LOEW, D.D.S, LLC
Entity Type:Organization
Organization Name:BETH A. LOEW, D.D.S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOEW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-487-0112
Mailing Address - Street 1:2164 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4053
Mailing Address - Country:US
Mailing Address - Phone:614-487-0112
Mailing Address - Fax:614-487-8949
Practice Address - Street 1:2164 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4053
Practice Address - Country:US
Practice Address - Phone:614-487-0112
Practice Address - Fax:614-487-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty