Provider Demographics
NPI:1710172226
Name:LOUDON, MERLE EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MERLE
Middle Name:EUGENE
Last Name:LOUDON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MERLE
Other - Middle Name:EUGENE
Other - Last Name:LOUDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:512 E. WASHINGTON STREET, SUITE #1
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382
Mailing Address - Country:US
Mailing Address - Phone:360-683-3892
Mailing Address - Fax:360-683-8864
Practice Address - Street 1:512 E. WASHINGTON STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382
Practice Address - Country:US
Practice Address - Phone:360-683-3892
Practice Address - Fax:360-683-8864
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00002665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist