Provider Demographics
NPI:1770702383
Name:LLOYD, ROBERT CALVIN JR (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CALVIN
Last Name:LLOYD
Suffix:JR
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 649
Mailing Address - Street 2:FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-0649
Mailing Address - Country:US
Mailing Address - Phone:928-729-8898
Mailing Address - Fax:928-729-8888
Practice Address - Street 1:CORNER OF ROUTE N12 AND N7
Practice Address - Street 2:FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504-0649
Practice Address - Country:US
Practice Address - Phone:928-729-8898
Practice Address - Fax:928-729-8888
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK5206122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5206OtherDENTAL LICENSE