Provider Demographics
NPI:1912645615
Name:LOOS, ARTHUR STUART (DDS)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:STUART
Last Name:LOOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1353 RIVERSTONE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5209
Mailing Address - Country:US
Mailing Address - Phone:770-345-8300
Mailing Address - Fax:770-345-8305
Practice Address - Street 1:1353 RIVERSTONE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5209
Practice Address - Country:US
Practice Address - Phone:770-345-8300
Practice Address - Fax:770-345-8305
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA101001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics