| Stuart Loos Ddd Llc | |
|
1353 Riverstone Pkwy Suite 130 Canton GA 30114-5634 | |
| (770) 345-8300 | |
| (770) 345-8305 |
| Full Name | Stuart Loos Ddd Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1353 Riverstone Pkwy, Canton, Georgia |
| Authorized Official Name and Position | Sally J Loos (MANAGER) |
| Authorized Official Contact | 7703458300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stuart Loos Ddd Llc 1353 Riverstone Pkwy Suite 130 Canton GA 30114-5634 Ph: (770) 345-8300 | Stuart Loos Ddd Llc 1353 Riverstone Pkwy Suite 130 Canton GA 30114-5634 Ph: (770) 345-8300 |
| NPI Number | 1295123685 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 01/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295123685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 10100 (Georgia) | Primary |
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