Provider Demographics
NPI:1821358649
Name:LOVELAND, ALYSSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 DIVISION ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-3662
Mailing Address - Country:US
Mailing Address - Phone:715-213-3292
Mailing Address - Fax:
Practice Address - Street 1:2201 DIVISION ST
Practice Address - Street 2:SUITE B
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-3662
Practice Address - Country:US
Practice Address - Phone:715-213-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6885-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist