Provider Demographics
NPI:1558505933
Name:LOUTFI, GEORGE (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:LOUTFI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2600
Mailing Address - Country:US
Mailing Address - Phone:609-890-0810
Mailing Address - Fax:609-890-0620
Practice Address - Street 1:2211 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-2600
Practice Address - Country:US
Practice Address - Phone:609-890-0810
Practice Address - Fax:609-890-0620
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02218000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist