Provider Demographics
NPI:1639226319
Name:LOE, FRED A (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:A
Last Name:LOE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:5424 RUFE SNOW DR
Mailing Address - Street 2:#103
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6684
Mailing Address - Country:US
Mailing Address - Phone:817-281-7100
Mailing Address - Fax:817-281-7135
Practice Address - Street 1:5424 RUFE SNOW DR
Practice Address - Street 2:#103
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6684
Practice Address - Country:US
Practice Address - Phone:817-281-7100
Practice Address - Fax:817-281-7135
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX175811223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery