Provider Demographics
NPI:1740781038
Name:LOVELESS, ANDREA (RDH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 GETTY DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1202
Mailing Address - Country:US
Mailing Address - Phone:406-212-5299
Mailing Address - Fax:
Practice Address - Street 1:147 GETTY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1202
Practice Address - Country:US
Practice Address - Phone:406-212-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist