Provider Demographics
NPI:1790839918
Name:DONALD H. LOUGH JR., D.D.S., INC.
Entity type:Organization
Organization Name:DONALD H. LOUGH JR., D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOUGH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-243-9010
Mailing Address - Street 1:98 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6241
Mailing Address - Country:US
Mailing Address - Phone:304-243-9010
Mailing Address - Fax:304-243-9013
Practice Address - Street 1:98 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6241
Practice Address - Country:US
Practice Address - Phone:304-243-9010
Practice Address - Fax:304-243-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty