Provider Demographics
NPI:1679566426
Name:SPICCIATI, LOUIS VINCENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:VINCENT
Last Name:SPICCIATI
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 1:3233 W CAREFREE CIR
Mailing Address - Street 2:BUILDING G
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-3004
Mailing Address - Country:US
Mailing Address - Phone:719-597-2400
Mailing Address - Fax:719-573-5633
Practice Address - Street 1:3233 W CAREFREE CIR
Practice Address - Street 2:BUILDING G
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3004
Practice Address - Country:US
Practice Address - Phone:719-597-2400
Practice Address - Fax:719-573-5633
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO715122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist