Provider Demographics
NPI:1538548813
Name:LOVELL, MARTA (DDS)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43044-1111
Mailing Address - Country:US
Mailing Address - Phone:937-834-2252
Mailing Address - Fax:937-834-2269
Practice Address - Street 1:18 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:OH
Practice Address - Zip Code:43044-1111
Practice Address - Country:US
Practice Address - Phone:937-834-2252
Practice Address - Fax:937-834-2269
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist