Provider Demographics
NPI:1740386663
Name:LLOYD NATTKEMPER, DDS, INC.
Entity Type:Organization
Organization Name:LLOYD NATTKEMPER, DDS, INC.
Other - Org Name:LLOYD NATTKEMPER, DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:NATTKEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-649-3661
Mailing Address - Street 1:880 CASS ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2947
Mailing Address - Country:US
Mailing Address - Phone:831-649-3661
Mailing Address - Fax:831-649-3690
Practice Address - Street 1:880 CASS ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2947
Practice Address - Country:US
Practice Address - Phone:831-649-3661
Practice Address - Fax:831-649-3690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321481223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty