Doctor Name: | DR. LOUIS RAY GERKEN |
NPI Number: | 1033118179 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S. |
License Number: | 100946 |
Business Practice Address: | 2800 Madison Square Dr Suite 1 Loveland, CO - 805383358 |
Business Phone Number: | 9706697711 |
Business Fax Number: | 9706692491 |
Mailing Address: | 2800 Madison Square Dr, Suite 1 LOVELAND |
State: | CO |
Postal Code: | 805383358 |
Phone Number: | 9706697711 |
Fax Number: | 9706692491 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 04/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/20/2006 |
NPI Reactivation Date: | 03/23/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 100946 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |