Provider Demographics
NPI:1659700011
Name:SPIEGEL, LOUIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2344
Mailing Address - Country:US
Mailing Address - Phone:516-797-0300
Mailing Address - Fax:516-797-5570
Practice Address - Street 1:875 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2344
Practice Address - Country:US
Practice Address - Phone:516-797-0300
Practice Address - Fax:516-797-5570
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034409-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist