Provider Demographics
NPI:1922155969
Name:ROBERT M. LOFTIN, D.D.S., M.S., P.A.
Entity Type:Organization
Organization Name:ROBERT M. LOFTIN, D.D.S., M.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-288-1966
Mailing Address - Street 1:2601 OAKCREST AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4722
Mailing Address - Country:US
Mailing Address - Phone:336-288-1966
Mailing Address - Fax:
Practice Address - Street 1:2601 OAKCREST AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4722
Practice Address - Country:US
Practice Address - Phone:336-288-1966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty