Provider Demographics
NPI:1902116940
Name:LLOYD, BENJAMIN ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:LLOYD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 JOHN DEERE PKWY
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8072
Mailing Address - Country:US
Mailing Address - Phone:309-278-0345
Mailing Address - Fax:
Practice Address - Street 1:7017 JOHN DEERE PKWY
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-8072
Practice Address - Country:US
Practice Address - Phone:309-278-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL319.0175091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice