Provider Demographics
NPI:1508001694
Name:LUEPKE, THOMAS HENRY III (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HENRY
Last Name:LUEPKE
Suffix:III
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 1:1102 REGIS CT
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4404
Mailing Address - Country:US
Mailing Address - Phone:715-835-3334
Mailing Address - Fax:715-552-1552
Practice Address - Street 1:1102 REGIS CT
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4404
Practice Address - Country:US
Practice Address - Phone:715-835-3334
Practice Address - Fax:715-552-1552
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5025-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice