Provider Demographics
NPI:1801288014
Name:MARVIN D. LOYD, DDS
Entity type:Organization
Organization Name:MARVIN D. LOYD, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:LOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-265-2024
Mailing Address - Street 1:3109 LAKESHORE DR N
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-9534
Mailing Address - Country:US
Mailing Address - Phone:870-265-2024
Mailing Address - Fax:
Practice Address - Street 1:880 E GAINES ST
Practice Address - Street 2:
Practice Address - City:DERMOTT
Practice Address - State:AR
Practice Address - Zip Code:71638-9609
Practice Address - Country:US
Practice Address - Phone:870-538-2046
Practice Address - Fax:870-538-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1558261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental