Provider Demographics
NPI:1033118179
Name:GERKEN, LOUIS RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:RAY
Last Name:GERKEN
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 1:2800 MADISON SQUARE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3358
Mailing Address - Country:US
Mailing Address - Phone:970-669-7711
Mailing Address - Fax:970-669-2491
Practice Address - Street 1:2800 MADISON SQUARE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3358
Practice Address - Country:US
Practice Address - Phone:970-669-7711
Practice Address - Fax:970-669-2491
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2014-04-28
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
CO1009461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry