Richard Merwin Lofthouse Sr., D.D.S.
Individual provider Active NPI General Practice Dentistry · Fennimore, WI
NPI 1609096833 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609096833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2811-015 (WI)
- Practice address
- 220 Lincoln Ave
Fennimore, WI 53809 - Phone
- (608) 822-3770
- NPI assigned
- Apr 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2811-015 | WI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2811-015 | WI | Yes |
Addresses
Primary practice location
220 Lincoln Ave
Fennimore, WI 53809
Mailing address
220 Lincoln Ave
Fennimore, WI 53809
Phone (608) 822-3770
Other providers in Fennimore, WI
- Nicole M Kaiser
- Lori Lynn Kartman
- Kaitlin Kersten
- Rita M. Lease
- Zhenyu Liang
- Lea Marie Lovell
- Eric Mark Lowe
- Marissa Lynch
- Memorial Hospital of Boscobel
- Memorial Hospital of Boscobel
All providers in Fennimore, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.