Provider Demographics
NPI:1174141667
Name:LLOYD, ANSLEE (DDS)
Entity type:Individual
Prefix:
First Name:ANSLEE
Middle Name:
Last Name:LLOYD
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 1:4807 W HOMESPUN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7667
Mailing Address - Country:US
Mailing Address - Phone:573-778-2240
Mailing Address - Fax:
Practice Address - Street 1:3555 HIGHWAY 412 E STE 10
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-7090
Practice Address - Country:US
Practice Address - Phone:479-373-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7350122300000X
AR4448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist