Provider Demographics
NPI:1417997685
Name:LODES, EUGENE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:L
Last Name:LODES
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 1:685 CITADEL DR E
Mailing Address - Street 2:SUITE 302
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909
Mailing Address - Country:US
Mailing Address - Phone:719-596-1011
Mailing Address - Fax:719-596-6748
Practice Address - Street 1:685 CITADEL DR E
Practice Address - Street 2:SUITE 302
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5314
Practice Address - Country:US
Practice Address - Phone:719-596-1011
Practice Address - Fax:719-596-6748
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist