Provider Demographics
NPI:1336153956
Name:LLOYD, RONNIE D (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:D
Last Name:LLOYD
Suffix:
Gender:M
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:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-0128
Mailing Address - Country:US
Mailing Address - Phone:252-459-2516
Mailing Address - Fax:252-459-8876
Practice Address - Street 1:105 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1327
Practice Address - Country:US
Practice Address - Phone:252-459-2561
Practice Address - Fax:252-459-8876
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8995358Medicaid