Provider Demographics
NPI:1841586641
Name:IGOE, PETER D (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:IGOE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2222 CLEARVIEW PKWY
Mailing Address - Street 2:STE. 1
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2437
Mailing Address - Country:US
Mailing Address - Phone:504-302-4204
Mailing Address - Fax:504-454-0855
Practice Address - Street 1:2222 CLEARVIEW PKWY
Practice Address - Street 2:STE. 1
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2437
Practice Address - Country:US
Practice Address - Phone:504-302-4204
Practice Address - Fax:504-454-0855
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY107951223G0001X
TX359201223G0001X
IN12013882A1223G0001X
LA61921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice