Provider Demographics
NPI:1720572167
Name:LOVETTE, DESIREE (DMD)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:LOVETTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15813 W ALVARADO DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7587
Mailing Address - Country:US
Mailing Address - Phone:559-410-0364
Mailing Address - Fax:
Practice Address - Street 1:1300 S WATSON RD # A-100
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-6303
Practice Address - Country:US
Practice Address - Phone:623-386-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ100251223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice