Provider Demographics
NPI:1922195965
Name:LEMIEUX, PETER G (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:LEMIEUX
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 1:5309 CYPRESS RESERVE PL
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9428
Mailing Address - Country:US
Mailing Address - Phone:407-681-6222
Mailing Address - Fax:
Practice Address - Street 1:1185 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4907
Practice Address - Country:US
Practice Address - Phone:407-644-2700
Practice Address - Fax:407-644-1989
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN146061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice