Provider Demographics
NPI:1689844219
Name:WILLIAM H LLOYD
Entity Type:Organization
Organization Name:WILLIAM H LLOYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:208-324-8861
Mailing Address - Street 1:119 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:ID
Mailing Address - Zip Code:83338-6147
Mailing Address - Country:US
Mailing Address - Phone:208-324-8861
Mailing Address - Fax:208-324-8899
Practice Address - Street 1:119 COUNTRY LN
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-6147
Practice Address - Country:US
Practice Address - Phone:208-324-8861
Practice Address - Fax:208-324-8899
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-14781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID9201692OtherIDAHO SMILES