Provider Demographics
NPI:1760594741
Name:LOFTUS, BRIAN P (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:P
Last Name:LOFTUS
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 NAZARETH RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2017
Mailing Address - Country:US
Mailing Address - Phone:610-252-5224
Mailing Address - Fax:610-252-8321
Practice Address - Street 1:3311 NAZARETH RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2017
Practice Address - Country:US
Practice Address - Phone:610-252-5224
Practice Address - Fax:610-252-8321
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-029911-L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics