Provider Demographics
NPI:1275672578
Name:PEEDE, LOUIE F JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIE
Middle Name:F
Last Name:PEEDE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:L.
Other - Middle Name:F
Other - Last Name:PEEDE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 22919
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222
Mailing Address - Country:US
Mailing Address - Phone:303-755-1500
Mailing Address - Fax:303-755-0125
Practice Address - Street 1:801 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846
Practice Address - Country:US
Practice Address - Phone:303-755-3353
Practice Address - Fax:303-755-0125
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1009721223S0112X
KS66451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery